Superficial Keratectomy with Cryopreserved Amniotic Membrane for Ocular Surface Optimization in Patients with Epithelial Basement Membrane Dystrophy

S Wade Kimmell Department of Optometry, Eye Surgeons of Indiana, Lafayette, IN, USACorrespondence: S Wade Kimmell, Optometry, Eye Surgeons of Indiana, 1400 Teal Road Ste 8, Lafayette, IN, 47905, USA, Tel +1-765-477-2020, Fax +1+765-477-8200, Email wade.kimmell@esi-in.comPurpose: Epithelial Basement Membrane Dystrophy (EBMD)-induced irregular astigmatism can lead to unreliable biometry and suboptimal refractive outcomes in cataract surgery patients. Herein, we assessed the use of superficial keratectomy followed by placement of cryopreserved amniotic membrane (cAM) to improve the ocular surface.Methods: This was a single-center, retrospective study of consecutive patients with EBMD that underwent superficial keratectomy with adjunctive treatment with cAM between November 2022 and March 2025. Time to complete epithelialization, visual acuity (LogMAR), higher order aberration Root Mean Square (HOA RMS), cylinder power, and IOL biometry were assessed up to two months post-treatment.Results: A total of 27 eyes of 21 patients with EBMD were included in the study and received cAM for a mean of 3.0 ± 0.4 days. Complete re-epithelialization was noted in an average 7.0 ± 4.7 days, with 96.3% (26/27) of eyes achieved epithelialization within 10 days. At the two month follow up, LogMAR VA slightly improved from 0.34 ± 0.21 to 0.31 ± 0.23 (p=0.42). HOA RMS significantly improved from 0.68 ± 0.53 μm to 0.42 ± 0.23 μm (p=0.006), and cylinder power significantly changed from 1.38 ± 0.75 D to 1.09 ± 0.71 D (p=0.022).Conclusion: Superficial keratectomy with cAM led to complete re-epithelialization in the majority (96.3%) of cases within 10 days, which was associated with a significant change in HOA RMS, cylinder power and IOL SE. This treatment may be considered in patients prior to cataract surgery to return the cornea to healthy state and change the biometry input for IOL selection.Keywords: amniotic membrane, anterior basement membrane dystrophy, cataract surgery, cryopreservation, debridement, epithelial basement membrane dystrophy, keratectomy, ocular surface