Prof. Christina Grupcheva:”Amniotic membrane transplantation – perceptual, visual, cosmetic outcomes”

Abstract

Purpose: To evaluate perceptual, visual and cosmetic outcomes of amniotic membrane transplantation (AMT) and follow the effect in time.
Methods: Six hundred and fifty seven subjects (723 eyes) were followed over period of five years. Most of the eyes had 1 AMT (528 eyes), 68 eyes had two AMT, and the rest had 3 and more procedures. The mean age was 55.2years , with the youngest patient being 1 years old and the oldest 95 years. Etiological diversity included bullose keratopathy (33%), burns and trauma (22%), corneal dystrophies (31%), limbal stem cell insufficiency (12%) and other (2%). All eyes received standard AMT as a cover, performed by the protocol of a single surgeon. The quality of eye comfort (perceptual, visual and cosmetic) was evaluated on the basis of specially developed scales.
Results: The subjects were with slightly female predominance (61%). The most significant perceptual improvement was related to pain which improved mean of 3 fold in 1 week, and kept improving till 4-th week. The other perceptual signs (tearing and discomfort) improved with lower speed. Visual acuity improved in direct correlation with the etiology and the best results were achieved in patients with epithelial erosions and defects. Cosmetic comfort improved in 65% of cases but usually not earlier then 4 weeks. No worsening of the symptoms was reported by any subject.
Conclusion:
This study highlights the importance of AMT not only for structural restauration but also for improving the life quality via achieving better perceptual, visual and cosmetic comfort of patients with anterior surface disease. The procedure is with easy learning curve and would be even simplified in the future and should be considered in wider indications for complete fast restauration of the ocular surface.

Curriculum Vitae

Prof. Dr. CN Grupcheva graduated as a medical doctor at Medical University of Varna, and following specialized training became a specialist in ophthalmology in 1996. She continued her studies with short fellowships at Moorfields Eye Hospital, London and Dundee University, UK. In 2000 she relocated to New Zealand as a Senior Research Fellow at Auckland University and Corneal Fellow at Auckland State Hospital for three years. During that period she completed a PhD with high commendations and Best Doctorial Thesis Prize of Auckland University for 2002. On return to Varna she was appointed as Associated Director of Specialized Eye Hospital Varna and shortly after as Associated Professor at Medical University of Varna. In 2007 she was invited to complete a DSc and in 2010 was elected a full National Professor in Ophthalmology.

Prof. Grupcheva’s clinical and research interests and expertise are related to cornea, anterior segment, tear film, in vivo confocal microscopy, contact lenses and complex anterior segment surgery. She has published more than 150 scientific papers and 14 ophthalmology books. She has Hi index of 40 and more than 3000 citations over the last 15 years. She actively participates as editor in American Academy of Ophthalmology textbooks revision and is reviewer for several prestigious journals. In 2018 she was appointed as TFOS ambassador. Professor Grupcheva teaches at all graduate and postgraduate levels and currently supervises 8 PhD students and 12 residents in ophthalmology. She has many high commendations graduates at different levels. She regularly presents at national and international meetings on subjects of her expertise, mainly as an invited lecturer. She is a member of number of Bulgarian, European and International learned societies and is a board member for International Council of Ophthalmology and European Cataract and Refractive Surgery Society board co-opted member.