Role Of Amniotic Membrane Transplantation Research Articles

Bedside sutureless amniotic membrane transplantation in acute Stevens–Johnson syndrome

Toxic epidermal necrolysis and Stevens–Johnson syndrome (SJS) are part of a spectrum of blistering diseases after hypersensitivity reaction to drugs, with ocular involvement in 69%–84% cases. The role of amniotic membrane transplantation (AMT) has been well established in the patients of SJS in reducing chronic long-term morbidity and sequelae. Herein, we present a report of 2 cases where bedside sutureless AMT was done within the first 5 days of onset. Amniotic membrane was secured in a symblepharon ring made using Ryle's tube. Both the cases had favorable outcomes and show the role of bedside and urgent AMT in these eyes.

Role of Amniotic Membrane Transplantation in Corneal Ulcers

Role of Amniotic Membrane Transplantation in Corneal Ulcers

Commentary: The role of amniotic membrane transplantation in the management of acute ocular chemical burns.

Commentary: The role of amniotic membrane transplantation in the management of acute ocular chemical burns.

Role of Amniotic Membrane Transplantation in Brittle Cornea Syndrome-A Case Report

Role of Amniotic Membrane Transplantation in Brittle Cornea Syndrome-A Case Report

Simultaneous use of amniotic membrane and Mitomycin C in trabeculectomy for primary glaucoma.

Purpose:This study aimed to propose the role of amniotic membrane transplantation (AMT) as an additional modulator in primary Mitomycin C (MMC)-augmented trabeculectomy.Methods:This was a randomized prospective interventional study. Forty eyes of 39 adult patients with uncontrolled primary glaucoma were randomly divided into two equal groups. Control group underwent trabeculectomy augmented with MMC while the study group underwent additional AMT. Patients were followed up for 12 months and outcomes measured were intraocular pressure (IOP), need for additional intervention, and bleb morphology.Results:Complete success (defined as IOP <16 mmHg on no medication) could be achieved in 85% eyes in study group while it was 60% in control group (P = 0.04). IOP reduced by 71.1% in study group from 41.9 ± 10.6 to 12.1 ± 2.7 mmHg and from 40.5 ± 8.5 to 12.8 ± 4.5 mmHg in control group, a decline of 68.29%. Blebs in AMT group showed better bleb morphology in terms of significantly better extent (E3) on day 1 (P = 0.03) and better height (H2 and H3) (P = 0.04), according to the Indiana Bleb Appearance Grading Scale, at all follow-up visits along with normal vascularity. The study group required significantly lesser (P = 0.03) bleb needlings as compared to control group.Conclusion:Amnion enhanced the efficacy of MMC-modulated trabeculectomy in terms of eyes with complete success and lesser interventions such as bleb needling. This reiterates the role of amnion as a safe and effective bleb modulator. A diffusely elevated bleb with healthier conjunctiva can go a long way in predicting better health and longevity of the bleb.

Role of Amniotic Membrane Transplantation in Symblepharon

Role of Amniotic Membrane Transplantation in Symblepharon

Simultaneous Use of Amniotic Membrane and Mitomycin C in Trabeculectomy for Primary Glaucoma: A Pilot Study

Purpose: Role of amniotic membrane transplantation as an additional modulator in primary Mitomycin C augmented trabeculectomy. Design: Randomised prospective interventional study. Methods: 40 eyes of 39 adult patients with uncontrolled primary glaucoma were randomly divided into 2 equal groups. Control group underwent trabeculectomy augmented with Mitomycin C while the study group underwent additional amniotic membrane transplantation. Patients were followed up for 12 months and outcomes measured were Intraocular Pressure, need for additional intervention and bleb morphology. Results: Complete success (defined as intraocular pressure <16 mmHg on no medication) could be achieved in 85% eyes in study group while it was 60% in control group (p=0.04). Intraocular pressure reduced by 71.1% in study group from 41.9 ± 10.6 mmHg to 12.1±2.7 mm Hg and from 40.5 ± 8.5 mmHg to 12.8 ± 4.5 mmHg in control group, a decline of 68.29%. Blebs in amniotic membrane transplantation group showed better bleb morphology in terms of significantly better extent (E3) on day 1 (p=0.03) and better height (H2 and H3) (p=0.04), according to Indiana Bleb Appearance Grading Scale, at all follow up visits along with normal vascularity. The study group required significantly lesser (p=0.03) bleb needlings as compared to control group. Conclusion: Amnion enhanced the efficacy of Mitomycin C modulated trabeculectomy in terms of eyes with complete success and lesser interventions like bleb needling. This reiterates the role of amnion as a safe and effective bleb modulator. A diffusely elevated bleb with healthier conjunctiva can go a long way in predicting better health and longevity of the bleb.

Adjuvant Role of Amniotic Membrane Transplantation in Acute Ocular Stevens–Johnson Syndrome: A Randomized Control Trial

To evaluate the adjuvant role of amniotic membrane transplantation (AMT) in cases of acute ocular Stevens-Johnson syndrome (SJS).Prospective randomized controlled clinical trial.Twenty-five patients (50 eyes) with acute ocular SJS who presented within 4 weeks of onset of symptoms were recruited.The eyes were randomized into 2 groups that underwent either AMT with medical therapy (MT; n = 25) or standard MT alone (n = 25). The patients were evaluated at presentation and during follow-up at 1 week and 1, 3, and 6 months. The parameters evaluated were the best-corrected visual acuity (BCVA), Schirmer test, tear film breakup time (TBUT), conjunctival congestion, corneal haze, vascularization, conjunctivalization, and limbal stem cell involvement. Lid edema, symblepharon, ankyloblepharon, ectropion, entropion, trichiasis, and metaplastic lashes also were analyzed.Maintenance of BCVA and stable ocular surface.At the end of 6 months, the mean BCVA was significantly better in the AMT group (0.068±0.10 logMAR units) compared with the MT group (0.522±0.52 logMAR units; P = 0.042). The mean TBUT in the AMT and MT groups was 9.92±4.1 and 6.96±4.5 seconds, respectively (P = 0.015). The mean Schirmer test results in the AMT and MT groups were 15.4±6.3 and 8.64±5.4 mm, respectively (P < 0.001). Conjunctival congestion persisted in 44% (11/25) in the MT group compared with 4% (1/25) in the AMT group (P = 0.03) at the end of the 6-month follow-up. No case in the AMT group demonstrated corneal haze, limbal stem cell deficiency, symblepharon, ankyloblepharon, or lid-related complications. Among eyes in the MT group, corneal haze occurred in 44% (11/25; P = 0.001), corneal vascularization and conjunctivalization in 24% (6/25; P = 0.03), symblepharon in 16% (4/25; P = 0.12), ankyloblepharon in 4% (1/25; P = 1.00), ectropion and entropion in 8% (2/25; P = 0.47), and trichiasis and metaplastic lashes in 24% (6/25; P = 0.03) eyes.Amniotic membrane transplantation is a useful adjunct to conventional MT in maintaining BCVA and a stable ocular surface in cases of acute ocular SJS. Furthermore, the adjunctive use of AMT also helps to prevent intermediate-term ocular cicatricial sequelae.

Role of Amniotic Membrane Transplantation in Acute Chemical Injury

Lo, Kristine MD; Kohanim, Sahar MD; Trief, Danielle MD; Chodosh, James MD, MPH Author Information

Amniotic membrane transplantation as an adjunct to medical therapy in acute ocular burns

AimsTo evaluate the role of amniotic membrane transplantation in patients with acute ocular burns.MethodsIn a prospective, randomised, controlled clinical trial, 100 patients with grade II to IV acute ocular burns...

Corneal surface reconstruction - a short review

Corneal surface reconstruction - a short review

Comparative evaluation of Amniotic Membrane Transplantation with conventional medical treatment versus conventional medical treatment alone in Suppurative Keratitis

Background : To study the role of amniotic membrane transplantation in infective keratitis. Methods : A prospective, randomized study on two groups of 20 patients with infective keratitis was done. Group A : only conventional medical treatment. Group B: conventional medical treatment with amniotic membrane transplantation was done. Results The mean age of patients was 46.30 ± 19.23 years. At 1 week follow-up, the improvement in symptoms like pain, redness, photophobia, watering and discharge was present in 24%, 4%, 25%, 28% respectively in patients without AMT, whereas it was 48%, 26%, 55% and 48% respectively in patients with AMT. The improvement in signs like size of corneal ulcer and hypopyon was 10% and 13% in patients without AMT, whereas it was 35.2% and 54% respectively in patients with AMT.

Evaluation of Amniotic Membrane Transplantation as an Adjunct to Medical Therapy as Compared with Medical Therapy Alone in Acute Ocular Burns

To evaluate the role of amniotic membrane transplantation (AMT) in acute ocular burns. Prospective, randomized, controlled clinical trial. Patients with grade II to IV ocular burns within 3 weeks of injury were recruited. Thirty-seven patients, 7 of whom had bilateral involvement (total, 44 eyes), participated in the trial. Twenty eyes were included in group A (AMT) and 24 eyes were included in group B (controls). The eyes in the AMT group underwent AMT in addition to conventional medical therapy. In the control group, only conventional medical therapy was instituted. The patients' subjective assessments of relief of ocular discomfort, healing of the corneal epithelial defect, visual acuity, extent of corneal vascularization, formation of symblepharon, and tear function tests. At day 1, subjective ocular discomfort scores were reduced significantly in eyes with moderate burns in the AMT group compared with controls (P = 0.05), but there was no difference between the 2 groups in eyes with severe burns. The log mean percentage reduction in size of epithelial defect by day 7 was 7.43+/-0.89 after AMT and 6.23+/-1.10 with medical treatment alone in moderate grade burns at day 7 (P = 0.01), but there was no difference between the 2 groups in eyes with severe burns. There was no overall difference in the final visual acuity, symblepharon formation, corneal vascularization, and tear function tests between the 2 groups over the next 3 months and further follow-up. There was a high dropout rate for long-term follow-up. Amniotic membrane transplantation in eyes with acute ocular burns has advantages in terms of reduction of pain and promotion of early epithelialization in patients with moderate grade burns, but not so in severe burns. There seems to be no definite advantage to AMT over medical therapy alone in terms of improvement in visual acuity, appearance of symblepharon, corneal vascularization, and results of tear function tests on short-term follow-up.

Amniotic membrane transplantation in entropion surgery.

To evaluate the role of amniotic membrane transplantation in the management of cicatricial eyelid entropion. Prospective, noncomparative interventional case series. Eighteen consecutive patients with cicatricial entropion. A gray line lid split procedure with vertical anterior lamella repositioning was performed on 25 eyelids (upper or lower) of 18 patients with moderate to severe cicatricial entropion. Preserved human amniotic membrane (AM) was used to cover the bare tarsus up to the lid margin and secured with running 7-0 Vicryl. Impression cytology of the AM was performed at various stages postoperatively to study the epithelialization process. (1) Reepithelialization of bare tarsus, (2) extent of tarsal shrinkage, (3) recurrence of entropion. All the AM grafts took well. The most common complication was hemorrhage below the graft, which occurred in six cases. Complete success with no lashes touching the globe was achieved in 22 of 25 (88%) lids after a minimum follow-up of 12.0 months. The mean follow-up was 17.8 months. Two cases (qualified success) had recurrent trichiasis treated successfully with electrolysis. One case with severe trachomatous upper lid entropion recurred 14 months after surgery. The AM accelerated the epithelialization of bare tarsus; this was demonstrated by lack of fluorescein staining and reversion to skin color within 2 to 3 weeks. However, AM could not prevent tarsal shrinkage. Impression cytology demonstrated that features of conjunctival epithelium were present for the first postoperative month, but this was gradually replaced by squamous metaplasia, with keratinization appearing as early as 3 weeks postoperatively. The use of AM in a lid split procedure for correction of cicatricial entropion helps the bare tarsus epithelialize rapidly and improves the initial cosmetic result of surgery.

Role of amniotic membrane transplantation in ocular surface disorders

The advent of amniotic membrane (AM) and limbal stem cell grafts have transformed the treatment of diseases resulting in ocular surface failure. The current success may be attributed to cryopreservation of human AM, which retains its properties and renders the amniotic epithelial cells nonviable and thus nonimmunogenic. Its unique properties have prompted its application in a large number of ocular ailments. The present article reviews the properties of AM and its uses in ophthalmic practice. amniotic membrane transplantation; ocular surface disorders; chemical injury; dry eye.