A Modified Symblepharon Ring for Sutureless Amniotic Membrane Patch to Treat Acute Ocular Surface Burns

Liang, Xinghua; Liu, Zhi-Ping; Li, Naiyang; Huang, Minghai; Wang, Zhichong

doi:10.1097/bcr.0b013e318239f9b9

Cited by 21 publications

(16 citation statements)

References 19 publications

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“…ALDH/RA and TGFβ pathways, depending on the model system, may be either synergistic -as in the induction of Tregs -or antagonistic, resulting in suppression of TGFβ (44). In liver fibrosis, RA directly exacerbates hepatic stellate cell (HSC) function by enhancing plasminogen activator (PA) levels and thereby inducing proteolytic activation of latent TGFβ, resulting in enhanced collagen production (43).…”

Section: Discussionmentioning

confidence: 99%

Aldehyde dehydrogenase inhibition blocks mucosal fibrosis in human and mouse ocular scarring

Ahadome¹,

Abraham²,

Rayapureddi³

et al. 2016

JCI Insight

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Mucous membrane pemphigoid (MMP) is a systemic mucosal scarring disease, commonly causing blindness, for which there is no antifibrotic therapy. Aldehyde dehydrogenase family 1 (ALDH1) is upregulated in both ocular MMP (OMMP) conjunctiva and cultured fibroblasts. Application of the ALDH metabolite, retinoic acid (RA), to normal human conjunctival fibroblasts in vitro induced a diseased phenotype. Conversely, application of ALDH inhibitors, including disulfiram, to OMMP fibroblasts in vitro restored their functionality to that of normal controls. ALDH1 is also upregulated in the mucosa of the mouse model of scarring allergic eye disease (AED), used here as a surrogate for OMMP, in which topical application of disulfiram decreased fibrosis in vivo. These data suggest that progressive scarring in OMMP results from ALDH/RA fibroblast autoregulation, that the ALDH1 subfamily has a central role in immune-mediated ocular mucosal scarring, and that ALDH inhibition with disulfiram is a potential and readily translatable antifibrotic therapy.

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Section: Discussionmentioning

confidence: 99%

Aldehyde dehydrogenase inhibition blocks mucosal fibrosis in human and mouse ocular scarring

Ahadome¹,

Abraham²,

Rayapureddi³

et al. 2016

JCI Insight

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“…It is possible to retain large sheets of amniotic membrane in the conjunctival sac using symblepharon rings or conformers only . The procedure can be performed at the bedside relatively easily.…”

Section: Treatment Of Eye Involvement In Stevens–johnson Syndrome/toxmentioning

confidence: 99%

“…The procedure can be performed at the bedside relatively easily. A large retrospective study comparing the results of AMT in 39 sutureless, and 36 sutured cases, demonstrated better outcomes in sutureless than in sutured AMT …”

Section: Treatment Of Eye Involvement In Stevens–johnson Syndrome/toxmentioning

confidence: 99%

U.K. guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults 2016

et al. 2016

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“…A relatively easy alternative exists in the Prokera ring; however, it alone is not as effective at maintaining the forniceal space as a sutured amniotic membrane. A prior sutureless technique has been published by Liang, 14 but it utilizes specialty-made symblepharon rings and amnion sizes that are not commercially available.…”

Section: Discussionmentioning

confidence: 99%

“…Lastly, there may be problems with having the amnion bunch and crumple upon insertion of the symblepharon ring. 14 …”

Section: Introductionmentioning

confidence: 99%

Amnion Doughnut

Pruet

Queen

Kim

2014

Cornea

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Purpose To describe a novel surgical method for sutureless placement of amniotic membrane on the bulbar and palpebral conjunctiva in the setting of ocular-involving acute Stevens-Johnson syndrome. Methods Six days into an acute Stevens-Johnson episode, a 27-year-old male developed early symblepharon, despite aggressive lubrication and topical steroid therapy. He underwent symblepharon lysis and placement of an amniotic membrane wrapped around a symblepharon ring. Results The patient maintained 20/20 vision in each eye with no recurrent symblepharon formation except for the temporal canthus (which was not covered with amniotic membrane). Conclusion Amniotic-membrane-wrapped symblepharon rings provide a sutureless way to fixate amniotic membrane to the bulbar and palpebral conjunctiva with very good anatomic and functional outcomes in an acute Stevens-Johnson patient. Future research could be directed towards development of a symblepharon ring able to better protect the far temporal conjunctiva.

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A Modified Symblepharon Ring for Sutureless Amniotic Membrane Patch to Treat Acute Ocular Surface Burns

Cited by 21 publications

References 19 publications

Aldehyde dehydrogenase inhibition blocks mucosal fibrosis in human and mouse ocular scarring

Aldehyde dehydrogenase inhibition blocks mucosal fibrosis in human and mouse ocular scarring

U.K. guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults 2016

Amnion Doughnut

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