{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:58:53Z","timestamp":1781240333521,"version":"3.54.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medically refractory peripheral ulcerative keratitis (PUK) is a severe condition requiring urgent surgery. This study compares the clinical outcomes of amniotic membrane transplantation (AMT) combined with cryotherapy vs. lamellar keratoplasty (LKP) for this high-risk group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study evaluated patients with refractory PUK who underwent either AMT or LKP with a 12-month follow-up. Outcome measures included ulcer healing rate, best-corrected visual acuity (BCVA), epithelialization time, and recurrence rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 58 patients (58 eyes) were included (AMT:\n                      <jats:italic>n<\/jats:italic>\n                      = 28; LKP:\n                      <jats:italic>n<\/jats:italic>\n                      = 30). Primary ulcer healing rates were comparable between the groups (AMT: 78.6%, LKP: 76.7%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.862). Both groups showed similar BCVA improvements up to 6 months postoperatively. However, the LKP group demonstrated significantly faster epithelialization (median 6 vs. 12 days;\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05), superior BCVA at 12 months (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.019), and a lower disease recurrence rate (10.0% vs. 32.1%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.038), although AMT demonstrated a superior safety profile with no procedure-related complications. Concurrent autoimmune diseases significantly prolonged epithelialization in both cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LKP provides superior long-term optical\/structural restoration and a lower recurrence rate, making it the definitive treatment for refractory PUK. However, AMT matches LKP in primary healing and mid-term efficacy. Amid global donor shortages, AMT serves as an invaluable, safe bridging therapy to stabilize the ocular surface and manage acute inflammation before definitive keratoplasty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1833378","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:47:08Z","timestamp":1781239628000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Amniotic membrane transplantation combined with cryotherapy vs. lamellar keratoplasty for medically refractory peripheral ulcerative keratitis: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jia","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiyao","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingxin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1016\/j.survophthal.2021.02.013","article-title":"Peripheral ulcerative keratitis","volume":"66","author":"Gupta","year":"2021","journal-title":"Surv Ophthalmol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1159\/000508325","article-title":"Peripheral ulcerative keratitis in a patient with bilateral scleritis: medical and surgical management","volume":"11","author":"Artaechevarria Artieda","year":"2020","journal-title":"Case Rep Ophthalmol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.semarthrit.2020.03.023","article-title":"Biologic therapy in severe and refractory peripheral ulcerative keratitis (Puk). 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