الفهرس | Only 14 pages are availabe for public view |
Abstract In 1910, Davis was the first to report the use of a fetal membrane as a surgical material for skin transplantation. In the 1940s, several authors reported the beneficial role of AM in treating a variety of ocular surface disorders; however, due to improper management of the tissue, the results were not impressive, until Kim and Tseng (1995) who reported the potential clinical application of preserved human AM that the tissue regained wide attention for ophthalmic use. Certain features make the AM ideal for its application in ocular surface reconstruction. The AM does not express immunological rejection, promotion of epithelialization, and possesses antifibroblastic, antibacterial, antivascularization and antiinflammatory properties. Amniotic membrane transplantation has been widely used successfully for many purposes in ocular surface disorders. It has been shown to be effective in promoting epithelial healing in persistent epithelial defect, in combination with limbal transplantation in Steven Johnson’s syndrome, and chemical burn to the cornea and conjunctiva, It has been also used as an alternative graft in pterygium excision, symblepharon and conjunctival tumors, as well as in revision of leaking blebs after glaucoma surgery, and haze reduction after laser photorefractive keratectomy. This study presents an experience with 74 amniotic membrane transplantations for different ocular surface pathologies with two different forms of Amniotic membrane transplantation. The 74 eyes were divided into three groups according to pathology and type of implant. group I included 40 eyes with amniotic membrane grafts after resection of recurrent pterygium. group II included 14 eyes with amniotic membrane grafts for symblepharon repair, and group III consisted of 20 eyes with amniotic membrane grafts for resistant corneal epithelial defects. group I demonstrated rapid healing of the lesions with minimal scarring in 30 of 40 eyes. In group II a favorable response was observed in 10 of 14 cases. In group III complete healing was achieved in 15 of 20 cases. Intra-and postoperative complications were observed during an average follow-up period of mean of 6 months including, recurrence of the pterygium, pyogenic granuloma, and dislodgement of the AM, symblepharon formation and motility restriction, in group I, II. Infection and resistanance of healing reported in few cases of group II. These results have proved the efficacy and safety of amniotic membrane transplantation in different ocular surface disorders, reducing the recurrence of pterygium, helping in fornix reconstruction in symblepharon and promoting epithelialization of persistent corneal epithelial defects. |