Effectiveness of Amniotic Membrane Transplantation in Corneal Ulcer Healing: A Systematic Review.

Corneal ulcers are a major cause of visual morbidity and blindness worldwide, and conventional treatments often fall short, particularly in chronic or neurotrophic cases. Amniotic membrane transplantation (AMT) has emerged as a promising adjunctive therapy due to its regenerative, anti-inflammatory, and anti-scarring properties. This systematic review evaluated the effectiveness of AMT in promoting corneal ulcer healing by assessing epithelialization time, visual acuity improvement, and complications. A comprehensive search of five databases - PubMed, Cochrane Library, Scopus, Web of Science, and the Virtual Health Library - was conducted up to April 20, 2024, including randomized controlled trials and prospective clinical studies published in English over the past decade. Nine studies were included, involving diverse patient populations and ulcer etiologies. AMT consistently accelerated epithelial healing, with reduced healing times compared to controls, early postoperative pain relief, and visual acuity improvements, particularly in central ulcers. Adverse effects were infrequent, and graft failure was rare. However, differences in technique and outcome measures limited comparability across studies. Overall, AMT appears to be a safe and effective adjunctive treatment for corneal ulcers, enhancing healing, comfort, and vision. Further validation through standardized protocols and high-quality multicenter trials is recommended to support clinical implementation.