{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T12:54:45Z","timestamp":1776862485629,"version":"3.51.2"},"reference-count":65,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T00:00:00Z","timestamp":1626912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: To evaluate new indicators in the efficacy of amniotic membrane transplantation (AMT) for non-healing corneal ulcers (NHCUs). Methods: Retrospective, multicenter study. In total, 223 AMTs for NHCU in 191 patients were assessed. The main outcomes studied were the success rate of AMT (complete re-epithelization), postoperative visual acuity (VA) gain, and number of AM layers transplanted. Results: The overall AMT success rate was 74.4%. In 92% of our patients VA stability or improvement. Postoperative VA was significantly higher than preoperative VA in the entire cohort (p &lt; 0.001) and in all etiological groups of ulcers (post-bacterial, p \u2264 0.001; post-herpetic, p \u2264 0.0038; neurotrophic ulcers, p \u2264 0.014; non-rheumatic peripheral, p \u2264 0.001; and ulcers secondary to lagophthalmos and eyelid malposition or trauma, p \u2264 0.004). Most participants (56.5%) presented a preoperative VA equal to or less than counting fingers (\u22640.01). Of these, 13.5% reached a postoperative VA equal to or better than legal blindness (\u22650.05) after AMT. A higher success rate was observed in the monolayer than in the multilayer AMT (79.5% and 64.9%, respectively; p = 0.018). No statistically significant values were found between the number of layers transplanted and VA gain (p = 0.509). Conclusion: AMT is not only beneficial in achieving complete re-epithelialization in NHCUs but also in improving postoperative VA; these improvements are independent of etiologies of ulcers. Furthermore, the use of monolayer AMT seems to be a more appropriate option than multilayer AMT for NHCU since the multilayer AMT did not present better outcomes (success rate and VA gain) compared to monolayer AMT in the different types of ulcers studied.<\/jats:p>","DOI":"10.3390\/jcm10153234","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T22:35:31Z","timestamp":1626993331000},"page":"3234","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Visual Acuity and Number of Amniotic Membrane Layers as Indicators of Efficacy in Amniotic Membrane Transplantation for Corneal Ulcers: A Multicenter Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7625-7078","authenticated-orcid":false,"given":"Javier","family":"Lacorzana","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Virgen de las Nieves University Hospital, 18006 Granada, Spain"},{"name":"Doctoral Program in Clinical Medicine and Public Health, University of Granada, 18006 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Campos","sequence":"additional","affiliation":[{"name":"Tissue Engineering Group, Department of Histology, University of Granada, 18006 Granada, Spain"},{"name":"Institute of Biosanitary Research ibs. Granada, University of Granada, 18006 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1815-6017","authenticated-orcid":false,"given":"Marina","family":"Brocal-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Son Espases University Hospital, 07120 Palma de Mallorca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Mar\u00edn-Nieto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Virgen de la Victoria University Hospital, 29010 Malaga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oswaldo","family":"Dur\u00e1n-Carrasco","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Nuestra Se\u00f1ora de la Candelaria University Hospital, 38010 Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esly C.","family":"Fern\u00e1ndez-N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Nuestra Se\u00f1ora de la Candelaria University Hospital, 38010 Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2688-9173","authenticated-orcid":false,"given":"Andr\u00e9s","family":"L\u00f3pez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Reina Sof\u00eda University Hospital, 30003 Murcia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1488-2660","authenticated-orcid":false,"given":"Jose L.","family":"Gonz\u00e1lez-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Juan Ram\u00f3n Jimenez, University Hospital, 21005 Huelva, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantinos","family":"Petsoglou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Sydney Eye Hospital, Sydney 2100, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose L. Garc\u00eda","family":"Serrano","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, San Cecilio University Hospital, 18006 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4103\/tjo.tjo_5_20","article-title":"Amniotic membrane transplantation for managing dry eye and neurotrophic keratitis","volume":"10","author":"Mead","year":"2020","journal-title":"Taiwan J. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19861","DOI":"10.1038\/s41598-020-76963-w","article-title":"The architecture of corneal stromal striae on optical coherence Tomography and histology in an animal model and in humans","volume":"10","author":"Napoli","year":"2020","journal-title":"Sci. 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