Decellularized Human Amniotic Membrane Treats Severe Keratoconjunctivitis Sicca

A decellularized human amniotic membrane can successfully treat patients with severe keratoconjunctivitis sicca, according to a poster presented at the American Optometric Association 2023 ePosters Virtual Event from June 13-14, 2023 in Washington, DC. 

Erich A. Hinel, OD, presented a case report of a man (age, 77 years; White) treated with the decellularized human amniotic membrane. The patient had severe keratoconjunctivitis sicca, which was more prominent in the left eye. For 1 month, he complained of reduced visual acuity in the left eye, but denied experiencing pain or discomfort. 

Presenting visual acuity was 20/40 and 20/125 for the right and left eyes, respectively, with diffuse punctate keratitis in the left eye, the poster shows. The patient had a significant history of glaucoma, which was well-controlled with dorzolamide-timolol for many years and corneal esthesiometry testing revealed reduced corneal sensitivities. 

Initially, the patient was treated with upper and lower lid punctal occlusion and therapeutic bandage contact lens management in the left eye. Moxifloxacin was added for prophylaxis.

At a 7-day follow-up visit, the patient’s visual acuity improved to 20/80, but diffuse puncta keratitis persisted. The patient underwent treatment with the decellularized human amniotic membrane due to inadequate treatment response.

At a visit conducted 2 weeks following the decellularized human membrane implantation, the patient’s visual acuity improved to 20/30 and there was marked improvement of the punctate keratitis. His clinical improvement was maintained with permanent punctal occlusion and autologous serum tears at 4-month follow up.

“This is the first reported case demonstrating the successful treatment of a patient with severe keratoconjunctivitis sicca with a novel 3-layer decellularized dehydrated human amniotic membrane,” according to the poster presenter. “Furthermore, this case illustrates the additive therapeutic benefit from amniotic membrane graft placement after inadequate therapeutic response with punctal occlusion and bandage contact lens management.”