Safety Of Amniotic Membrane Transplantation Research Articles

Retracted: Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium.

[This retracts the article DOI: 10.1155/2022/5844973.].

Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium.

Objective The aim of the study is to evaluate the safety and effectiveness of amniotic membrane transplantation combined with the closure of the tenon capsule and bulbar conjunctival space. Methods This study retrospectively included 100 patients with primary pterygium who received closed bulbar conjunctiva and tenon capsule space combined with amniotic membrane transplantation in our hospital from January 2020 to June 2021 as the experimental group and 100 patients with routine treatment in the same period as the control group. The postoperative efficacy evaluation and postoperative complications of the two groups were compared, so as to comprehensively evaluate the safety and effectiveness of this method. Results The results showed that the postoperative complications of the two groups were significantly improved by Fisher's exact test (χ2 = 14.510, P = 0.006 < 0.05). The comparison results showed that the treatment group showed significant advantages in six indexes compared with the observation group and the difference between the two groups was statistically significant (P < 0.05) of in the NRS score, Prabhasawat score, inspection of the ocular surface comprehensive analyzer, corneal fluorescein staining, conjunctival fluorescein staining in the operation area, breakup time of tear film examination of the two groups at 3, 7 and 14 days, and 1, 6 and 12 months after the operation. Conclusions Amniotic membrane transplantation combined with the closure of the tenon capsule and bulbar conjunctival space is safer than conventional surgery in the treatment of primary pterygium. It has a shorter recovery time, higher safety, and a positive curative effect. It can be considered to popularize this operation in clinic.

Amniotic membrane transplantation in failed trabeculectomy.

To determine the efficacy and safety of amniotic membrane transplantation for trabeculectomy in patients with previous failed filtering blebs. A consecutive series of 19 eyes from 18 patients with 1 or more failed trabeculectomies were enrolled in this retrospective study. Trabeculectomy, with amniotic membrane positioned as a "graft" under the scleral flap, was performed, and the intraocular pressure (IOP), number of antiglaucoma medications, appearance of the filtering bleb, and intraoperative and postoperative complication data were retrospectively analyzed for a period of 24 months. Success was defined as IOP<21 mm Hg at the end of the follow-up period. The median preoperative pressure was 29 mm Hg [interquartile range (IQR)=5 mm Hg], with an average of 2.8 glaucoma medications (range, 1 to 4). At 6 months postoperatively the median IOP was 18 mm Hg (IQR=1.75 mm Hg) with no further significant increases recorded, settling at 19 mm Hg (IQR=3.25 mm Hg) at the end of the 24-month follow-up. Success was achieved in all 19 cases (100%), and only 1 patient (5%) required postoperative antiglaucoma therapy to reach the target pressure. At 24 months after surgery, 18 of 19 (95%) amniotic membrane filtering blebs were functioning well without antiglaucoma therapy. No patients had severe intraoperative or postoperative complications. Amniotic membrane transplantation in trabeculectomy seems to be a safe and useful procedure for improving the surgical outcome and maintaining low postoperative IOP in patients with a high risk of surgical failure.

Effectiveness of amniotic membrane transplantation combined with mitomycin C in the treatment of pterygium: a meta-analysis.

To evaluate the recurrence rate and safety of amniotic membrane transplantation (AMT) augmented with mitomycin C (MMC) compared with amniotic membrane transplantation alone during the pterygium excision. We took a meta-analysis on this program. Pertinent studies were selected through extensive searches of the Cochrane Library, MEDLINE, EMBASE, CBMdisc, CNKI. Pooled estimates were carried out in RevMan software v.4.2. Six trials reported postoperative recurrence rate of pterygium, included 882 eyes, three trials reported the complications. The results of meta-analysis showed that recurrence rate of AMT plus MMC group was 5.41%, AMT alone group was 16.89%, RR was 0.32, 95%CI ranged from 0.19 to 0.56, Z was 4.06, P<0.001. Two trials reported early complication as punctata keratitis, the incidence rate of AMT plus MMC group and AMT alone group were 17.14% and 0.00%, RR was 12.11, 95%CI ranged from 1.62 to 90.76. Amniotic membrane transplantation with MMC was associated with lower recurrence rate compared with amniotic membrane transplantation alone in pterygium excision, whether accompanied a higher risk with adverse events need more investigation.

The results of amniotic membrane transplantation for primary pterygium compared with conjunctival autograft

A randomized, prospective study was performed to determine the efficacy and safety of amniotic membrane transplantation (AMT) vs conjunctival autograft (CAG) as adjunctive therapy after surgical excision of primary pterygium. Eighty-six eyes of 78 patients with pterygium that were either advancing more than 3 mm onto the cornea or causing extreme irritation were included in the study, randomized to either AMT (44 eyes of 39 patients) or CAG (42 eyes of 41 patients) as adjunctive therapy, and operated on by a single surgeon. The mean follow-up was 14.40 ± 5.4 months in the AMT group and 12.35 ± 3.13 months in the CAG group. There were 18 recurrences (40.9%) in the AMT group and 2 (4.8%) in the CAG group (P < .007). The cumulative proportion that were recurrence-free at 12 months was 0.6 ± 0.15 for the AMT group and 0.95 ± 0.07 for the CAG group (P = .0003, Log-rank test). The cumulative nonrecurrence rate at 6 and 12 months in all patients stratified by age and gender was not significantly different. No major complications were observed in either group. The authors conclude that amniotic membrane transplantation has an unacceptably high recurrence rate compared to conjunctival autograft transplantation as adjunctive therapy following excision of pterygium.—Michael D. Wagoner A randomized, prospective study was performed to determine the efficacy and safety of amniotic membrane transplantation (AMT) vs conjunctival autograft (CAG) as adjunctive therapy after surgical excision of primary pterygium. Eighty-six eyes of 78 patients with pterygium that were either advancing more than 3 mm onto the cornea or causing extreme irritation were included in the study, randomized to either AMT (44 eyes of 39 patients) or CAG (42 eyes of 41 patients) as adjunctive therapy, and operated on by a single surgeon. The mean follow-up was 14.40 ± 5.4 months in the AMT group and 12.35 ± 3.13 months in the CAG group. There were 18 recurrences (40.9%) in the AMT group and 2 (4.8%) in the CAG group (P < .007). The cumulative proportion that were recurrence-free at 12 months was 0.6 ± 0.15 for the AMT group and 0.95 ± 0.07 for the CAG group (P = .0003, Log-rank test). The cumulative nonrecurrence rate at 6 and 12 months in all patients stratified by age and gender was not significantly different. No major complications were observed in either group. The authors conclude that amniotic membrane transplantation has an unacceptably high recurrence rate compared to conjunctival autograft transplantation as adjunctive therapy following excision of pterygium.—Michael D. Wagoner

AMNIOTIC MEMBRANE TRANSPLANTATION IN THE TREATMENT OF SHIELD ULCER IN VERNAL KERATOCON JUNCTIVITIS.

Objectives: To evaluate the efficacy and safety of amniotic membrane transplantation (AMT) for thetreatment of shield ulcer in vernal keratoconjunctivitis (VKC) with giant papillae.Material and Methods: This retrospective study was conducted in the Department of ophthalmologyHayatabad Medical Complex Peshawar from May 2009 to May 2010. In this study 30 patients of VKC withshield ulcer were evaluated for a period of one year. Both gender of 3 - 26 years age patients were included inthis study. Patients were enrolled and informed written consent was taken. Amniotic membraneimplantation was performed in thirty patients with grade 2 or grade 3 shield ulcers unresponsive toconventional medical treatment lasting an average of 14 weeks. Surgery was done under general anesthesiausing amniotic membrane as a therapeutic contact lens. Their record was maintained and all patients withthe mean 4 months follow-up were evaluated for about safety, efficacy, and side effect of the treatment.Results: Thirty eyes of thirty patients with grade 2 shield ulcer with opaque base) and grade 3 (plaque likelesions) not responding to steroid therapy with or without surgical debridement were enrolled. The ulcershealed with disintegration or retraction of the membrane in all patients within 2 weeks. A significantdecrease in symptoms and complete reepithelialization of the corneal ulcers were observed in all caseswithin the first 7 days. The eyes remain stable during a mean follow-up of 4 months, with no intraoperativeor postoperative complications. Absorption of amniotic membrane occurred with in 2 to 3 weeks timeleaving the underlying ulcer completely epithelized.Conclusion: Amniotic membrane transplantation in combination with debridement is a safe and effectivesurgical modality in the management of shield ulcers. Further studies are warranted to confirm the efficacyof amniotic membrane transplantation in the management of shield ulcer.