Effects of amniotic membrane on wound healing and adhesions in experimental strabismus surgery

Demirel, Sibel; Atilla, Hüban; Heper, Aylin Okçu; Erkam, Necile

doi:10.1177/112067210901900601

Cited by 24 publications

(22 citation statements)

References 15 publications

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“…Amniotic membrane transplantation has been reported as a useful adjunct in strabismus surgery, decreasing adhesions by means of its anti‐inflammatory and antiscarring actions and by forming a temporary biological barrier between potentially adhesive surfaces (Yamada et al. 2001; Demirel et al. 2009; Sheha et al.…”

Section: Introductionmentioning

confidence: 99%

Effect of cryopreserved amniotic membrane on the development of adhesions and fibrosis after extraocular muscle surgery in rabbits

Kassem

Khodeir

Salem

et al. 2013

Acta Ophthalmologica

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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.

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Section: Introductionmentioning

confidence: 99%

Effect of cryopreserved amniotic membrane on the development of adhesions and fibrosis after extraocular muscle surgery in rabbits

Kassem

Khodeir

Salem

et al. 2013

Acta Ophthalmologica

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“…In a recent experimental controlled strabismus surgery study, AM was used under the superior rectus muscle of pigmented rabbits to prevent fibrosis and adhesion formation. The results show that AM has an antifibrotic effect and an effective role in the prevention of adhesion formation with possible physical barrier action [24]. A case report describing the use of AM to reduce adhesion formation in a patient with consecutive esotropia and limited duction showed possible benefits of this procedure [11].…”

Section: Discussionmentioning

confidence: 96%

Amniotic membrane in the management of strabismus reoperations

et al. 2012

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“…Brooks et al (30) performed an animal study, determined an increase in postoperative fibrosis formation in rabbits receiving MMC at a dose of 0.5 mg/mL, and attributed this increase to the difference in the behaviors of episcleral fibroblasts. Demirel et al (17) reported an experimental study and found that MMC significantly reduced adhesion formation as compared to the control group. In that particular study, although MMC was found to be successful also in reducing fibrosis formation as compared to the control group, this difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…It has an enhancing effect on epithelization and prevents inflammation, scarring, fibrosis, and neovascularization. Because of its weak immunity and good harmony with the surrounding tissues, amniotic membrane has been used in many clinical studies and reported in case reports (16,17). The use of some of these materials has been limited because they are prone to infection and unpractical.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of mitomycin-C and infliximab in reducing adhesionand fibrosis following strabismus surgery*

Güçlü¹,

Sari

Dinç

et al. 2016

Turk J Med Sci

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IntroductionAdhesion, fibrosis, and scarring formation following strabismus surgery are among the most important problems that unfavorably influence surgical success. The exact incidence of scars, adhesion, and fibrosis has not been reported but Ludwig retrospectively reviewed 134 reoperations in which a stretched scar was discovered and estimated that stretched scar tissue was a contributing factor in 10% of all strabismus reoperations and 50% of late overcorrections (1). Adhesion is the attachment that occurs in some tissues including the conjunctiva, Tenon's capsule, the intermuscular membrane, orbital adipose tissue, the sclera, and extraocular muscular tissue due to any reason during or after strabismus surgery. These adhesions may result from inappropriate surgical approach, excessive bleeding, cautery usage, suture reaction, postoperative infection, muscular capsule injury, migration of adipose tissue to the surgical area due to the laceration of the orbital septum, and multiple procedures performed in the same region (2). Fibrosis is the contracture occurring after inflammation of extraocular muscles. Appropriate surgical techniques should be performed to avoid postoperative adhesion and fibrosis and subsequent scarring (2,3).Adhesion, fibrosis, and scar formation after strabismus surgery bring along unfavorable consequences for both the patient and the surgeon. Need for a second surgery not only psychologically influences the patient negatively but also leads to further tissue injury during the second intervention and causes additional expense. Reducing adhesion, fibrosis, and scarring after strabismus surgery would provide results that are more satisfactory for both patients and surgeons by enhancing anatomical success. For this purpose, many materials and drugs have been studied in experimental or clinical trials; nevertheless, no Background/aim: The present study aimed to investigate the efficacy of mitomycin-C (MMC) and infliximab (INF) in reducing adhesion and fibrosis following strabismus surgery. Materials and methods:Forty eyes of 20 albino rabbits were separated into MMC and INF groups. Right and left eyes of rabbits were assigned to the drug and control groups, respectively. The superior rectus muscle was disinserted, the drug was administered to the surgical area for 5 min in the drug eyes (MMC 0.2 mg/mL or INF 5 mg/mL), and physiological saline was administered to the control eyes. Surgical areas were rinsed with 10 mL of physiological saline. The disinserted muscle was then sutured to the same area using 6.0 Vicryl. The rabbits were sacrificed after 4 weeks for histopathological examination.Results: Significant reduction was observed in fibrosis in the INF group as compared to the control group (P = 0.005). Although adhesion formation in the drug eyes reduced in the MMC and INF groups as compared to the control group, the difference was not significant (P = 0.280 and P = 0.579, respectively). Conclusion:This study demonstrated the fibrosis-preventing efficacy of IFN; thus, it can be a good o...

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Effects of amniotic membrane on wound healing and adhesions in experimental strabismus surgery

Abstract: According to our results, amniotic membrane has antifibrotic effect but no anti-inflammatory effect in rabbit eyes due to possible xenograft reaction to human tissues. It is effective in prevention of adhesion formation with possible physical barrier action.

Cited by 24 publications

References 15 publications

Effect of cryopreserved amniotic membrane on the development of adhesions and fibrosis after extraocular muscle surgery in rabbits

Effect of cryopreserved amniotic membrane on the development of adhesions and fibrosis after extraocular muscle surgery in rabbits

Amniotic membrane in the management of strabismus reoperations

Efficacy of mitomycin-C and infliximab in reducing adhesionand fibrosis following strabismus surgery*

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