Amniotic Membrane Transplantation for Persistent Epithelial Defects and Ulceration due to Pseudomonas Keratitis in a Rabbit Model

Purpose: The use of amniotic membrane has been suggested in the treatment ofinfectious keratitis for its intrinsic anti-infective properties probably mediated by its antiinflammatory effects. The aim of this study was to investigate the effect of amniotic membrane transplantation (AMT) along with ciprofloxacin to cure the primary stages of Pseudomonas keratitis. Methods: In total, 28 rabbits were selected and divided in four groups as follows: group 1 as control, group 2 with amniotic membrane, group 3 with ciprofloxacin, and group 4 with amniotic membrane combined with ciprofloxacin. About 0.05 cc suspension of Pseudomonas aeruginosa, 27853 ATCC was injected into corneal stroma. Results: The results showed groups of AMT, AMT + ciprofloxacin, and ciprofloxacin had 0% perforation while the control group had 85.6%. Average infiltration of 5.5 mm was observed in ciprofloxacin group, 5 mm in AMT + ciprofloxacin group, 24 mm in AMT group, and finally 23.75 mm for control. Amniotic membrane showed to be effective in prevention of cornea perforation as well as remission of Pseudomonas keratitis. There was no significant difference between ciprofloxacin groups in comparison with ciprofloxacin + AMT group. However, regarding the anti-inflammatory effect, the process of improvement of inflammation in ciprofloxacin + AMT group was faster. Conclusion: Transplantation of amniotic membrane in the primary stages of Pseudomonas keratitis treatment remarkably prevents the disease and it can be used to control its process.