Abstract
Purpose. The purpose of this study was to evaluate the efficacy of dried human amniotic membrane (AM) in reducing the postoperative inflammatory response and scarring after strabismus surgery. Methods. The inflammatory response at the extraocular muscle reattachment site was analyzed after superior rectus (SR) resection in 12 rabbits. Dried human AM (Ambiodry2) was applied between the resected SR muscle plane and Tenon's capsule of the left eyes of rabbits. As a control, the right eyes of rabbits underwent SR resection only. The surgeon randomly ordered which eye gets operated first during the experiment. Two weeks later, enucleation was performed. Six sagittal sections were made for each eye at the insertion of the SR muscle. The grade of postoperative inflammation and the presence of fibrosis were evaluated in histological examinations. Results. There was no statistically significant difference in the intensity of inflammation and fibrous proliferation between the eyes treated with dried human AM after SR resection and those treated with SR resection only. Conclusions. The use of dried human AM was not effective in controlling the postoperative inflammation and scarring in rabbit eyes after extraocular muscle surgery. However, this may be due to the devitalized dry preparation of human AM (Ambiodry2), which may have lost the expected anti-inflammatory and anti-scarring properties, and further studies on humans may be necessary.
Highlights
Postoperative adhesion is one of the major complications of strabismus surgery that can cause motility problems that affect the surgical outcomes [1, 2]
The degree of inflammation was graded in 6 consecutive sagittal sections in each eye
The amniotic membrane (AM) reduces the inflammation in a variety of ocular surface disorders through several mechanisms
Summary
Postoperative adhesion is one of the major complications of strabismus surgery that can cause motility problems that affect the surgical outcomes [1, 2]. Due to the fact that the suppression of inflammation is a key element in the prevention of further fibrovascular proliferation and scar formation in the conjunctiva [3], various approaches have been used to reduce postoperative inflammation and scarring following strabismus surgery. Among these are mechanical barrier devices that isolate the muscle from the sclera and the Tenon’s capsule, steroids, antiproliferative agents and viscoelastic substances [1,2,3,4,5,6,7,8,9]. AM exhibits several characteristics that might be of benefit in strabismus surgery, that is, good integration with surrounding tissue, a low-healing response, suppression of transforming growth factor-beta (TGF-β) activity, and poor immunogenicity [15]
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