# Superficial Keratectomy Alone versus in Combination with Amniotic Membrane Transplantation in Aniridia-Associated Keratopathy and a Short-Term Clinical Outcome

## TL;DR

This study compares two treatments for a severe eye condition in people born without an iris, finding both are equally effective in improving vision over six months.

## Contribution

The study provides new evidence that superficial keratectomy alone is as effective as combined treatment for advanced aniridia-associated keratopathy.

## Key findings

- Both superficial keratectomy alone and combined with amniotic membrane transplantation improved best corrected visual acuity in 92-94% of patients.
- No significant differences were found between the two treatments in visual outcomes or corneal neovascularization over six months.
- Superficial keratectomy alone is effective for advanced aniridia-associated keratopathy with partial limbal stem cell efficiency.

## Abstract

Background/Objectives: Aniridia-associated keratopathy (AAK) is a potentially vision-threatening pathology in congenital aniridia, for which both the underlying etiopathogenesis and effective treatment remain unclear. Methods:This prospective study was conducted to assess and compare the short-term outcome after superficial keratectomy (SK) alone or in a combination with an amniotic membrane transplantation (AMT). Here, 76 eyes were enrolled in 76 patients with grade 4 AAK. In all eyes, in order to assess preoperatively the efficiency of the limbal epithelial stem cells (LESC), the presence of corneal epithelial cells in confocal microscopy was established. The analyses included: best corrected visual acuity (BCVA), the stage of AAK and the number of corneal quadrants involved in corneal neovascularization (CNV). Results: Six months after surgery, the mean BCVA was 0.05 and ranged from 0.002 up to 0.1 in both groups. Improvement in BCVA occurred in 94.29% patients when *SK alone* was performed, and in 92.68% when in combination with AMT. There were no statistically significant differences in the effect of therapy depending on the type of surgery, regarding BCVA, stage of AAK and the number of quadrants with CNV. Conclusions: SK alone is an effective procedure in short outcomes limited to six months for advanced AAK in association with LESC partial efficiency.