Indications and Four-Week Epithelialisation After Amniotic Membrane Transplantation for Ocular Surface Disorders in Padang, Indonesia: A Retrospective Case Series

Abstract

Background: Amniotic membrane transplantation (AMT) is widely used for ocular surface reconstruction, but no indication or outcome series from Sumatra, Indonesia, was found.

Objective: To describe the indications and four-week outcome of AMT at a tertiary referral hospital and compare them with published series.

Methods: Retrospective case series (STROBE) of all patients undergoing AMT at Dr. M. Djamil General Hospital, Padang, January 2022–December 2024. A favourable course was epithelialisation at four weeks without further surgery. Proportions carried Wilson 95% confidence intervals (CI) and were compared with published series using exact tests with Holm adjustment. Outcome was not linked to patient characteristics at eye level, so associations were bounded across all datasets consistent with the aggregate totals.

Result: Forty-three patients (47 eyes; 27 men, 62.8%) were included. Corneal ulcer was the leading indication (28 eyes, 59.6%; 95% CI 45.3–72.4), followed by grade IV pterygium and Stevens–Johnson syndrome-related symblepharon (each 14.9%). At four weeks, 40 eyes (85.1%; 95% CI 72.3–92.6) had a favourable course; six underwent repeat AMT and one, with Mooren's ulcer, evisceration. Keratitis formed a larger share of indications than in a Turkish audit (8.0%; Holm p<0.001). The available data could neither establish nor exclude an association of outcome with indication, sex or age.

Conclusion: At this Indonesian referral centre, AMT served chiefly as corneal reconstruction for ulcerative keratitis, and most eyes epithelialised within four weeks. Reoperation followed perforating corneal disease, immune-mediated melt and cicatrising SJS. Prospective eye-level registries are needed to identify predictors of failure.