New clinical application of amniotic membrane transplant for ocular surface disease

The new defined anatomical and functional complex conjunctiva-limbus-cornea is a new concept, which helps clinicians better understand and treat ocular surface pathologies. The management of the ocular surface disease has changed dramatically over the years, with spectacular improvements of techniques, and of course, results. The amniotic membrane, used as a graft or as a substrate for the cultivation of limbal corneal cells has showed encouraging results. Aim: To investigate the usefulness of amniotic membrane transplantation in ocular surface pathologies. Method: The study is retrospective. 28 eyes of 28 patients with ocular surface pathologies (ocular burns, recent and old, symblepharon, pterygium, corneal and conjunctival tumors, persistent epithelial defect) underwent an amniotic membrane transplantation during a 1 year period. The necrotic and the scar tissue were first excised in all the patients and the amniotic membrane was sutured with an epithelial face up. Follow up ranged from 1 to 12 months. Results: Good results were obtained in all 28 eyes. The anatomy of cornea and conjunctiva was improved, with limited benefits only in old ocular burn, symblepharon and in one case of extended tumors of the cornea and conjunctiva. Out of 28 eyes, 23 (82%) also had a visual acuity improvement. Conclusion: The amniotic membrane may be considered a good alternative for ocular surface reconstruction especially in acute status. Abbreviations: AMT = amniotic membrane transplantation, BCVA = best corrected visual acuity, BUT = break up time

[1]  R. Tandon,et al.  Long-Term Outcomes of Cultivated Limbal Epithelial Transplantation: Evaluation and Comparison of Results in Children and Adults , 2015, BioMed research international.

[2]  D. Meller,et al.  Amniotic membrane transplantation in the human eye. , 2011, Deutsches Arzteblatt international.

[3]  B. Seitz.  [Amniotic membrane transplantation. An indispensable therapy option for persistent corneal epithelial defects]. , 2007, Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft.

[4]  I. Gipson,et al.  The ocular surface: the challenge to enable and protect vision: the Friedenwald lecture. , 2007, Investigative ophthalmology & visual science.

[5]  G. A. Limb,et al.  Transplantation of ex vivo cultured limbal epithelial stem cells: a review of techniques and clinical results. , 2007, Survey of ophthalmology.

[6]  Wei Li,et al.  How does amniotic membrane work? , 2004, The ocular surface.

[7]  E. Holland,et al.  Changing Concepts in the Management of Severe Ocular Surface Disease Over Twenty-five Years , 2000, Cornea.

[8]  S. Tseng,et al.  Suppression of TGF-ß signaling in both normal conjunctival fibroblasts and pterygial body fibroblasts by amniotic membrane , 2000 .

[9]  S. Tseng,et al.  Suppression of TGF-beta signaling in both normal conjunctival fibroblasts and pterygial body fibroblasts by amniotic membrane. , 2000, Current eye research.

[10]  K. Tsubota,et al.  Amniotic membrane transplantation for ocular surface reconstruction in patients with chemical and thermal burns. , 1997, Ophthalmology.