Outcome of amniotic membrane transplantation in ocular GVHD-related corneal melting: a retrospective case series

Purpose To investigate the outcome of single amniotic membrane transplantation (AMT) in the treatment of corneal melting associated with ocular graft-versus-host disease (oGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT), and to explore the correlative risk factors. Methods A retrospective case series study. Data of 303 patients with oGVHD were reviewed, and cases of corneal melting undergoing AMT were collected. Patients were divided into the single-AMT success group and the single-AMT failure group according to the recurrence of corneal melting within 6 months after receiving the initial AMT. The preoperative ocular assessments (including corneal fluorescence staining, conjunctival congestion, lid margin lesion score, and corneal optical coherence tomography) and characteristics related to HSCT were compared between the two groups. Results A total of 31 patients were enrolled in this retrospective study, comprising 21 males (67.74%). At 6 months after the initial AMT, 21 cases achieved corneal healing, while corneal melting recurred in 10 cases. There were no differences in the primary disease and donor sources between the single-AMT success group and the failure group. The incidence of lung GVHD in the failure group was higher than that in the success group (OR = 8.021, 95% CI: 1.379 to 64.902, p = 0.020). Conclusion Amniotic membrane transplantation can be used as a treatment for oGVHD-related corneal melting. Lung GVHD may be associated with the failure of single AMT surgery. It is recommended to strengthen postoperative immune regulation and follow-up management.