Abstract:Lyophilized amniotic membrane insignificantly reduces postoperative adhesions and fibrosis, when used to wrap the operated upon extraocular muscles, limiting the benefit of this membrane in strabismus surgery.
“…2009; Sheha et al. 2009; Kassem et al. 2010, 2011; Kassem 2011; Mehendale & Dagi 2011; Strube et al.…”
Section: Discussionunclassified
“…Kassem et al. (2011) performed the first histopathological study to evaluate the effect of lyophilized AM transplantation during superior rectus surgery in rabbits.…”
Section: Discussionmentioning
confidence: 99%
“…2004). Lyophilized AM transplant, however, had an insignificant effect on reducing postoperative adhesions and fibrosis after extraocular muscle surgery in rabbits, limiting the benefit of lyophilized AM in strabismus surgery (Kassem et al. 2011).…”
Section: Introductionmentioning
confidence: 99%
“…Bearing in mind the risk of transmission of communicable diseases posed by fresh AM (Ozkan et al. 2004), and the limited benefit of lyophilized AM (Kassem et al. 2010, 2011), this histopathological study was conducted to evaluate the effect of cryopreserved AM on the prevention of development of postoperative adhesions and fibrosis after extraocular muscle surgery in an experimental model.…”
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Purpose: To histopathologically evaluate the effect of cryopreserved human amniotic membrane (AM) transplant on preventing the development of postoperative adhesions after extraocular muscle surgery.
Methods: Ten albino rabbits were used. The superior rectus muscles were bilaterally resected. In right eyes, the muscle was wrapped with cryopreserved human AM (group AM). In left eyes, the muscle was not wrapped with AM and served as a control group (group C). The rabbits were killed, and the eyes were enucleated 6 weeks after surgery to perform histopathological examination.
Results: On histopathological examination, the AM was present in eight eyes, surrounded by periamniotic inflammation, with no adhesions detected between rectus muscle and sclera, conjunctiva and Tenon’s capsule in the segment where the AM was present, but detected elsewhere. Adhesions were detected in the other two eyes of group AM, in which the AM was absent, and in all group C eyes. When comparing eye pairs of each rabbit, AM eyes showed significantly less adhesions between the muscle and sclera (p = 0.009) and between the muscle and Tenon’s capsule and conjunctiva (p = 0.008), in the region of AM application, and significantly more foreign body inflammation (p = 0.031), than C eyes. The differences between AM and C eye pairs, in terms of conjunctival inflammation and vascularity and muscle fibrosis, were insignificant (p > 0.05).
Conclusions: Cryopreserved AM is effective in reducing postoperative extraocular muscle adhesions. Its application is, therefore, recommended during strabismus reoperations.
“…2009; Sheha et al. 2009; Kassem et al. 2010, 2011; Kassem 2011; Mehendale & Dagi 2011; Strube et al.…”
Section: Discussionunclassified
“…Kassem et al. (2011) performed the first histopathological study to evaluate the effect of lyophilized AM transplantation during superior rectus surgery in rabbits.…”
Section: Discussionmentioning
confidence: 99%
“…2004). Lyophilized AM transplant, however, had an insignificant effect on reducing postoperative adhesions and fibrosis after extraocular muscle surgery in rabbits, limiting the benefit of lyophilized AM in strabismus surgery (Kassem et al. 2011).…”
Section: Introductionmentioning
confidence: 99%
“…Bearing in mind the risk of transmission of communicable diseases posed by fresh AM (Ozkan et al. 2004), and the limited benefit of lyophilized AM (Kassem et al. 2010, 2011), this histopathological study was conducted to evaluate the effect of cryopreserved AM on the prevention of development of postoperative adhesions and fibrosis after extraocular muscle surgery in an experimental model.…”
.
Purpose: To histopathologically evaluate the effect of cryopreserved human amniotic membrane (AM) transplant on preventing the development of postoperative adhesions after extraocular muscle surgery.
Methods: Ten albino rabbits were used. The superior rectus muscles were bilaterally resected. In right eyes, the muscle was wrapped with cryopreserved human AM (group AM). In left eyes, the muscle was not wrapped with AM and served as a control group (group C). The rabbits were killed, and the eyes were enucleated 6 weeks after surgery to perform histopathological examination.
Results: On histopathological examination, the AM was present in eight eyes, surrounded by periamniotic inflammation, with no adhesions detected between rectus muscle and sclera, conjunctiva and Tenon’s capsule in the segment where the AM was present, but detected elsewhere. Adhesions were detected in the other two eyes of group AM, in which the AM was absent, and in all group C eyes. When comparing eye pairs of each rabbit, AM eyes showed significantly less adhesions between the muscle and sclera (p = 0.009) and between the muscle and Tenon’s capsule and conjunctiva (p = 0.008), in the region of AM application, and significantly more foreign body inflammation (p = 0.031), than C eyes. The differences between AM and C eye pairs, in terms of conjunctival inflammation and vascularity and muscle fibrosis, were insignificant (p > 0.05).
Conclusions: Cryopreserved AM is effective in reducing postoperative extraocular muscle adhesions. Its application is, therefore, recommended during strabismus reoperations.
“…The use of such agents should be regarded with caution as they may also decrease the reattachment of the extraocular muscle to the scleral tissue. The role of amniotic membrane to reduce postoperative scarring is studied by different groups and conflicting results are reported about the effect of reducing postoperative scarring161718192021222324.…”
Strabismus surgery may be responsible for some restrictions in ocular motility that may cause new problems after surgery. Most of the time these restrictions present as a complex motility problem after surgery that requires further treatment. There may be various reasons that cause motility restriction following strabismus surgery. Those are excessive shortening or inadvertent capture of extraocular muscles, transposition procedures and, the most challenging problem, postoperative scar tissue-adhesion formation. In this review the potential reasons for postoperative restrictive problems, preventive measures and finally the treatment options for such problems are overviewed.
Amniotic membrane (AM) is a naturally derived biomaterial with biological and mechanical properties important to Ophthalmology. The epithelial side of the AM promotes epithelialization, while the stromal side regulates inflammation. However, not all AMs are equal. AMs undergo different processing with resultant changes in cellular content and structure. This study evaluates the effects of sidedness and processing on human corneal epithelial cell (HCEC) activity, the effect of processing on HCEC inflammatory response, and then a case study is presented. Three differently processed, commercially available ocular AMs were selected: (1) Biovance ® 3L Ocular, a decellularized, dehydrated human AM (DDHAM), (2) AMBIO2 ® , a dehydrated human AM (DHAM), and(3) AmnioGraft ® , a cryopreserved human AM (CHAM). HCECs were seeded onto the AMs and incubated for 1, 4 and 7 days. Cell adhesion and viability were evaluated using alamarBlue assay. HCEC migration was evaluated using a scratch wound assay. An inflammatory response was induced by TNF-α treatment. The effect of AM on the expression of pro-inflammatory genes in HCECs was compared using quantitative polymerase chain reaction (qPCR). Staining confirmed complete decellularization and the absence of nuclei in DDHAM. HCEC activity was best supported on the stromal side of DDHAM. Under inflammatory stimulation, DDHAM promoted a higher initial inflammatory response with a declining trend across time. Clinically, DDHAM was used to successfully treat anterior basement membrane dystrophy. Compared with DHAM and CHAM, DDHAM had significant positive effects on the cellular activities of HCECs in vitro, which may suggest greater ocular cell compatibility in vivo.
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