Comparison between continuous and interrupted suturing of amniotic membrane grafting in surgical management of persistent epithelial defects

Purpose To evaluate continuous suturing of amniotic membrane grafts as an alternative to interrupted sutures for the surgical management of persistent epithelial defects. Patients and methods A retrospective chart review of 54 patients with corneal persistent epithelial defects who underwent amniotic membrane grafts either using a continuous suturing technique (group 1) or an interrupted suturing technique (group 2). All eyes were evaluated for amniotic membrane slippage on postoperative day 1 (POD 1). The surface area of the epithelial defect was measured on POD 7. Results Our study included 54 eyes with corneal persistent epithelial defects. Group 1 (27 patients) underwent continuous suture Amniotic membrane transplant (AMT), while group 2 (27 patients) underwent interrupted suture AMT. The most common cause of preoperative persistent defect was ocular cicatricial pemphigoid (48%). In group 1, one eye had slippage of the amniotic membrane on POD 1. The mean preoperative surface area of corneal PEDs was 21.2 mm 2 (range =4.8–45.4mm 2 ), while the mean postoperative surface area (POD 7) was 5.8 mm 2 (range=0–27mm 2 ) ( P <0.0001). In group 2 patients, six eyes showed slippage of the amniotic membrane in POD 1. The mean preoperative surface area of corneal PEDs was 21.6 mm 2 (range=4.8–45.0 mm 2 ), while the mean postoperative surface area (POD 7) was 8.6 mm 2 (range=0–30 mm 2 ) ( P <0.01). All eyes healed within 1 month postoperatively. Conclusion Continuous suturing technique is noninferior to the standard interrupted suturing technique of the amniotic membrane grafting regarding healing of PEDs. Moreover, interrupted suturing is more liable for slippage. Continuous suturing is easier and takes less surgical time.