To determine whether amniotic membrane transplantation improves the outcomes among patients with bacterial keratitis considering the visual acuity, corneal healing time, hypopyon size and duration, size of ulcer and depth of corneal opacity, Langerhans cells density and neovascularization and the need for tectonic procedures.

In this prospective randomized clinical trial 99 eyes from 99 patients with bacterial keratitis were randomly divided into two groups each. The first group (Case group) received routine antibiotic therapy followed by single-layer amniotic membrane transplantation and the second group (Control group) only received routine antibacterial therapy. The main outcomes including visual acuity, corneal healing time, size and depth of corneal opacity, Langerhans cells density and neovascularization were followed for a six months period.

Our results indicated statistically significant better best corrected visual acuity (p<0.001), uncorrected visual acuity (p=0.002), pinhole corrected visual acuity (p<0.001) as well as contact lens corrected visual acuity (p=0.002) at six months in the case group compared to control group. Corneal healing time and the depth of corneal opacity as well as hypopyon size and duration were not significantly lower in the case group while the size of corneal opacity (p=0.001) was significantly smaller. Also significantly less corneal vascularization (p<0.001) and Langerhans cells density (p<0.001) was observed at one month in the case group.

The early use of amniotic membrane transplantation treatment of patients with bacterial keratitis was associated with better outcomes compared to antibiotic therapy alone. More comparative studies to investigate the probable side effects as well as the cost benefit of this method are granted.