Clinicopathological insights into amniotic membrane integration following combined Descemet stripping automated endothelial keratoplasty and amniotic membrane transplantation in bullous keratopathy

Amniotic membrane transplantation (AMT) is commonly used to reconstruct the ocular surface, offering anti-inflammatory, antifibrotic, and epithelial healing benefits. However, its integration and long-term behavior on the cornea are not fully understood. We report a case of bullous keratopathy treated with combined Descemet stripping automated endothelial keratoplasty and amniotic membrane graft (AMG) for symptom relief. The AMG was removed after epithelialization. Histological and immunohistochemical analysis of the excised membrane revealed structural integration with corneal epithelial cells, providing insights into epithelial regeneration and membrane incorporation. These findings highlight AMG’s active role in promoting healing and could inform improved surgical techniques for ocular surface repair.