Effectiveness of Cryopreserved Amniotic Membrane Transplantation in Corneal Ulceration: A Meta-Analysis

Purpose: To evaluate the effectiveness of cryopreserved amniotic membrane transplantation (AMT) in corneal ulceration. Methods: The following electronic databases were searched: PubMed, EMBASE, and Cochrane Library. We evaluated the corneal epithelium healing rate (CEHR) and vision improvement rate (VIR) after AMT in the treatment of corneal ulceration. We analyzed the differences in the CEHR and VIR between the 2 groups of infective and noninfective corneal ulcerations. Subgroup analysis for the CEHR and VIR was performed based on the surgical methods. There were 3 subgroups: single-layered inlay, multilayered inlay, and sandwich (SAN). The differences were tested by referring to the Cochrane Handbook. Pooled estimates were determined with STATA software, version 15. Results: Eighteen eligible studies reporting the outcomes in 390 eyes of 385 patients were included. The results of the meta-analysis showed that the pooled CEHR was 97% (I 2 = 37.9%, 95% confidence interval: 0.94–0.99, P = 0.089). The pooled VIR was 53% (I 2 = 68.1%, 95% confidence interval: 0.42–0.65, P < 0.001). There were no significant differences in either the CEHR or the VIR between the 2 groups of infective and noninfective corneal ulcerations. Among the 3 subgroups of single-layered inlay, multilayered inlay, and SAN, the differences in both CEHR and VIR were statistically significant. Conclusions: Consistent with many published reports, this meta-analysis also concluded that AMT was effective in the treatment of corneal ulceration. The curative effect of AMT was not different between the infective and noninfective corneal ulcerations. The differences in both CEHR and VIR were statistically significant among the subgroups.