Volume 53, Issue 6 p. 1268-1276

Commercial amniotic membrane extract for treatment of corneal ulcers in adult horses

Victoria N. Lyons

Victoria N. Lyons

Department of Veterinary Clinical Sciences, Purdue University, Indiana, USA

Search for more papers by this author
Wendy M. Townsend

Corresponding Author

Wendy M. Townsend

Department of Veterinary Clinical Sciences, Purdue University, Indiana, USA


Wendy M. Townsend, Department of Veterinary Clinical Sciences, Purdue University, Indiana, USA.

Email: [email protected]

Search for more papers by this author
George E. Moore

George E. Moore

Department of Comparative Pathobiology, Purdue University, Indiana, USA

Search for more papers by this author
Siqi Liang

Siqi Liang

Department of Statistics, College of Science, Purdue University, Indiana, USA

Search for more papers by this author
First published: 15 December 2020
Citations: 8

Funding information

Purdue University, Department of Veterinary Clinical Sciences, Graduate Student Competitive Research Funds.

The abstract is available in German in the Supporting Information section of the online version of this article.



Amniotic membrane extract enhances the rate of epithelialisation after corneal ulceration in several species but has not been studied in the equine cornea.


To evaluate the effect of amniotic membrane extract on re-epithelialisation of equine corneal ulcers compared with ulcers treated with antibiotic, antifungal and mydriatic medical therapy alone, and to evaluate equine corneal healing after experimentally induced superficial ulceration.

Study design

Masked, randomised, controlled experimental trial.


Superficial, 8 mm corneal ulcers were created bilaterally in each horse. One eye was treated with amniotic membrane extract and the opposite was control. Both eyes were treated with medical therapy. Treatment eyes received amniotic membrane extract, and control eyes received the amniotic membrane extract vehicle. Ulcers were stained with fluorescein and photographed in 12-hour increments until completely healed. Ulcer surface area was determined by analysing photographs with ImageJ. A mixed linear model was used to compare ulcer surface area and hours until healing between treatment groups. A regression model was also used to calculate corneal re-epithelialisation rate over time.


Regardless of therapy, healing occurred in two phases: an initial rapid phase of 0.88 mm2/hr (95% CI: 0.81-0.94 mm2/hr) for approximately 48-54 hours followed by a second, slow phase of 0.07 mm2/hr (95% CI: 0.04-0.09 mm2/hr). Most eyes healed within 135.5 ± 48.5 hours. Treatment (amniotic membrane extract vs. control) was not significantly associated with size of ulcers over time (P = .984). Discomfort was minimal to absent in all horses.

Main limitations

Results achieved experimental studies may differ from outcomes in the clinical setting.


There was no significant difference in healing rate with addition of amniotic membrane extract to medical therapy for equine superficial corneal ulcers. A biphasic corneal healing process was observed, with an initial rapid phase followed by a slow phase. Further study will be needed to determine whether amniotic membrane extract will be helpful for infected or malacic equine corneal ulcers.


No competing interests have been declared.

Peer Review

The peer review history for this article is available at https://publons.com/publon/10.1111/evj.13399.