Management of ocular surface disease involving inflammation and persistent epithelial defects utilising various treatment modalities in the UK National Health Service (NHS)

Abstract

Objective To evaluate clinical outcomes and resource utilisation of conventional treatment modalities for ocular surface disease involving inflammation and persistent epithelial defect (PED) in an NHS setting, and to compare outcomes with sutureless human amniotic membrane-derived dry matrix (HAMDM) as an alternative therapy.

Methods A retrospective clinical study of 30 patients with PED was conducted across two centres. Treatment duration, healing rates, outpatient (OP) burden, and associated costs were analysed. Outcomes were benchmarked against pooled data from prior studies with HAMDM at the same centres.

Results Conventional management achieved complete healing in 57% of patients, with a mean treatment duration of 176 ± 188 days and 10 OP visits per case. Adjunctive procedures such as tarsorrhaphy (83%) and amniotic membrane transplantation (AMT, 34%) were frequently required. The average total cost per patient was £ 4900 ± £ 3363. In comparison, patients treated with HAMDM achieved higher resolution rates (63%), shorter treatment duration (98 days), fewer OP appointments (8 per case), and a lower treatment cost.

Conclusion PED poses a substantial clinical and economic burden within the NHS. Standard treatments are prolonged and resource-intensive. HAMDM represents a clinically effective and cost-saving alternative, potentially reducing treatment duration, OP burden and overall healthcare costs. Hospital Episode Statistics (HES) data revealed over 138,000 PED-related episodes annually in the NHS, primarily managed in non-surgical settings. These findings therefore support further integration of sutureless amniotic membrane into first-line care strategies for ocular surface disease involving inflammation and PED.