Amniotic membrane transplantation for ocular surface reconstruction: indications and outcomes

Maharajan, V. Senthil; Shanmuganathan, Vijay; Currie, A.D.M.; Hopkinson, Andrew; Powell-Richards, A; Dua, Harminder S.

doi:10.1111/j.1442-9071.2006.01408.x

Cited by 72 publications

(57 citation statements)

References 38 publications

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“…As mentioned above, the prognosis is worse for progressive cicatrising conjunctival disease (with associated chronic inflammation) than for stable, non-progressive cicatrisation. 27 Glaucoma Similar to its use in symblepharon treatment, AM has been used as an adjunct in glaucoma surgery and as a treatment option in its complications. Its main purpose has been to reduce scarring at the time of filtering surgery, to repair early or late leaks, and act as a cover for valve procedures.…”

Section: Symblepharonmentioning

confidence: 99%

Amniotic membrane in ophthalmology: indications and limitations

Rahman

Said

Maharajan

et al. 2009

Eye

147

107

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The amniotic membrane remains a useful tool in the treatment of several ophthalmic conditions, especially those related to the ocular surface. However, the 'success' reported in individual case reports and case series is not substantiated in the few published randomised controlled trials. More often than not, it is not as good as existing alternative options and, at best, is as good but with probably an increased cost. The variable outcomes could be related to inter and intra donor variations in the membrane and the depletion or alterations in its constituents subsequent to processing and storage. The membrane thus is a fairly 'non-standardised product' making comparisons of different applications and indications difficult. The potential for 'epidemic' infections, such as HIV, hepatitis B and C, is a serious issue as, in many parts of the world, fresh unquarantined membrane, at times with no tests for the above infectious agents, is being used. The exact mechanism of action of the membrane is not known but the consensus is that it acts as a substrate or scaffold for host cells to populate and thus facilitate healing and repair. The development of a standard 'synthetic membrane' using collagen or polymer matrices impregnated with putative beneficial ingredients, such as growth factors and antimicrobials, is being considered and may prove to be a step in the right direction.

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Section: Symblepharonmentioning

confidence: 99%

Amniotic membrane in ophthalmology: indications and limitations

Rahman

Said

Maharajan

et al. 2009

Eye

147

107

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“…The hAM is an abundant birthing tissue that, due to its unique structure, composition, and neonatal derivation, has had promising results when used in a number of tissue repair applications. [11][12][13][14][15][16][17]33 Based on these clinical successes and a novel approach that takes advantage of the hAM's unique properties, we have developed a concentric rolling approach that aims at rapidly forming cell-dense and mechanically stable tissue-engineered blood vessels.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17] However, all these applications have used the hAM as an acellular material, without taking advantage of the material's capacity to be seeded or used as a layered construct to speed and potentially enhance tissue regeneration. The hAM presents a number of desirable characteristics (advantageous for blood vessel regeneration and a wide range of tissue-engineering applications), including biocompatibility, biostability, noninflammatory, nontoxic, noncarcinogenic, nonimmunogenic, 17 vasoactivity, thromboresistance, 18 ability to remodel, 16 infection resistance, suture-holding capacity, 19 and its wide availability.…”

mentioning

confidence: 99%

Rolling the Human Amnion to Engineer Laminated Vascular Tissues

Amensag

McFetridge

2012

Tissue Engineering Part C: Methods

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The prevalence of cardiovascular disease and the limited availability of suitable autologous transplant vessels for coronary and peripheral bypass surgeries is a significant clinical problem. A great deal of progress has been made over recent years to develop biodegradable materials with the potential to remodel and regenerate vascular tissues. However, the creation of functional biological scaffolds capable of withstanding vascular stress within a clinically relevant time frame has proved to be a challenging proposition. As an alternative approach, we report the use of a multilaminate rolling approach using the human amnion to generate a tubular construct for blood vessel regeneration. The human amniotic membrane was decellularized by agitation in 0.03% (w/v) sodium dodecyl sulfate to generate an immune compliant material. The adhesion of human umbilical vein endothelial cells (EC) and human vascular smooth muscle cells (SMC) was assessed to determine initial binding and biocompatibility (monocultures). Extended cultures were either assessed as flat membranes, or rolled to form concentric multilayered conduits. Results showed positive EC adhesion and a progressive repopulation by SMC. Functional changes in SMC gene expression and the constructs' bulk mechanical properties were concomitant with vessel remodeling as assessed over a 40-day culture period. A significant advantage with this approach is the ability to rapidly produce a cell-dense construct with an extracellular matrix similar in architecture and composition to natural vessels. The capacity to control physical parameters such as vessel diameter, wall thickness, shape, and length are critical to match vessel compliance and tailor vessel specifications to distinct anatomical locations. As such, this approach opens new avenues in a range of tissue regenerative applications that may have a much wider clinical impact.

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“…Without the limbal stem cells and corneal epithelial cells, the cornea may not maintain avascularity and clarity because of secondary conjunctivalization and neovascularization of the cornea. In a retrospective case study, Maharajan et al (2007) reported the correlation between a higher success rate of ocular surface reconstruction using amniotic membrane transplantation and the availability of stem cells. There are some minor disadvantages of amniotic membrane transplantation.…”

Section: Disadvantages Of Human Amniotic Membranementioning

confidence: 99%