Commercial amniotic membrane extract for treatment of corneal ulcers in adult horses.
Authors: Lyons Victoria N, Townsend Wendy M, Moore George E, Liang Siqi
Journal: Equine veterinary journal
Summary
# Editorial Summary: Amniotic Membrane Extract for Equine Corneal Ulcers Corneal ulceration is a common equine ophthalmic condition, and whilst amniotic membrane extract has demonstrated efficacy in accelerating epithelialisation across several species, its therapeutic value in horses remained unestablished. Lyons and colleagues conducted a masked, randomised, controlled trial using experimentally induced bilateral 8 mm superficial corneal ulcers in horses, treating one eye with commercial amniotic membrane extract alongside standard medical therapy (antibiotics, antivirals and mydriatics) whilst the contralateral eye received vehicle control with identical medical support; ulcer healing was tracked photographically with fluorescein staining at 12-hourly intervals and analysed using image analysis software to quantify re-epithelialisation rates. The research revealed a consistent biphasic healing pattern independent of treatment group: an initial rapid phase averaging 0.88 mm²/hour over approximately 48–54 hours, followed by a markedly slower phase of 0.07 mm²/hour, with complete healing typically achieved within 135.5 ± 48.5 hours, yet critically, no statistically significant difference emerged between amniotic membrane extract and control eyes (P = 0.984). Whilst these findings suggest that commercially available amniotic membrane extract offers no additional benefit for uncomplicated superficial corneal ulcers managed with conventional topical therapy, the authors appropriately acknowledge that results may differ in infected or melting ulcers—scenarios that warrant further investigation—and clinicians should therefore continue relying on established medical protocols rather than adopting this adjunctive therapy based on current evidence.
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Practical Takeaways
- •Commercial amniotic membrane extract does not accelerate healing of simple superficial corneal ulcers in horses when combined with standard antibiotic, antifungal, and mydriatic therapy—standard medical management remains the evidence-based approach
- •Expect biphasic healing with rapid initial epithelialisation (first 48-54 hours) followed by slower maturation; plan follow-up examinations accordingly
- •Further research is needed before recommending amniotic membrane extract for complicated cases such as infected or malacic ulcers, where it may have different efficacy
Key Findings
- •Amniotic membrane extract showed no significant difference in healing rate compared to control (P = 0.984) when added to standard medical therapy for equine superficial corneal ulcers
- •Corneal healing occurred in two biphasic phases: rapid phase of 0.88 mm²/hr for 48-54 hours followed by slow phase of 0.07 mm²/hr
- •Most equine corneal ulcers healed within 135.5 ± 48.5 hours regardless of treatment group
- •Discomfort was minimal to absent in all horses during healing regardless of therapy