Transplantation in ophthalmology—single-center perspectives

INTRODUCTION: Corneal and amniotic membrane transplantations are the most frequently performed transplantations in the world. Amniotic membrane transplantation demonstrates very high efficiency in the management of the ocular surface damaged by disease or trauma. AIM: The goal of the current study is to prospectively follow and analyze the tendency in ocular transplantation in a single center in Bulgaria. MATERIALS AND METHODS: A group of 206 patients were recruited in total for a period of three years. Of them 28 had corneal transplantation and 158 had amniotic membrane transplantation. Corneal transplant patients were pre-registered on the waiting list and operated as emergency cases due to the short period of time in which the corneal material preserves best quality. Patients for amniotic membrane were planned in general, but 1/3 were operated as a matter of emergency (102 planned and 56 urgent). The procedures were performed following the standard protocols. RESULTS: The results outline the role of amniotic membrane as a follow-up treatment in 1/3 of the cases. After emergency transplantation of amniotic membrane, 12 cases underwent re-operation—corneal transplantation, and 11 received a planned second amniotic membrane transplant. These findings also highlight the main advantage of amniotic membrane—absence of graft rejection and possibility for unlimited re-grafting. Another highlight is the larger number of corneal dystrophies, which underscores the benefits of amniotic membrane transplantation not only for comfort but also for visual improvement. CONCLUSION: In conclusion, amniotic membrane transplantation in Bulgaria follows the international standards, however, corneal transplantation requires revision including the legal regulations, eye bank protocols, and end-user approaches. In the future, tissue engineering will contribute to the provision of more tissue and facilitation of complicated restauration surgeries of the damaged ocular