Management of Persistent Corneal Epithelial Defects with Human Amniotic Membrane-derived Dry Matrix

Maqsood, Sundas; Elsawah, Kareem; Dhillon, Navpreet K.; Soliman, Shady; Laginaf, Masara; Lodhia, Vaishali; Lake, Damian; Hamada, Samer; El‐Alfy, Mohamed

doi:10.2147/opth.s299141

Cited by 15 publications

(27 citation statements)

References 33 publications

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“…19 Maqsood et al reported the results of Omnigen (NuVision Biotherapies Ltd, Nottingham, United Kingdom), which is a dehydrated AM applied under a BCL (OmniLenz; NuVision Biotherapies Limited), in the management of persistent corneal epithelial defects of various etiologies. 14 They reported that 58% of the eyes showed complete healing and 28% showed partial decrease in size of PEDs with average treatment length recorded as 22.4612.3 days. 14 Our results showed similar healing rates as those reported in the studies by Mimouni et al and Maqsood et al In this study, 72.7% of the eyes healed completely after placement of a single graft, and 100% eyes healed after two grafts and remained free of epithelial defects for a mean of 7.5 months.…”

Section: Discussionmentioning

confidence: 99%

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Sutureless Lyophilized Amniotic Membrane Grafting for Corneal Epithelial Defects

Delbarre

Boucenna

Froussart-Maille

2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objectives: To report the tolerability, safety, and efficacy of the lyophilized amniotic membrane (AM) Visio-AMTRIX placed under a bandage contact lens (BCL) in treating persistent epithelial defects (PEDs). Methods: This retrospective study included consecutive patients with PEDs treated with a lyophilized AM placed under the BCL. Patients with PEDs who did not respond to medical treatment were included. Patients with a follow-up time less than 3 months were excluded. Results: Eleven eyes of 11 patients (mean age, 61.6615.9 years) were included. Time from PED presentation to AM transplantation (AMT) was 27.764.9 days, with the mean PED area of 13.2611.3 mm 2 . Complete resolution was achieved in 8 of 11 eyes after a single AM graft. The epithelial defect persisted after the first AMT in three eyes (27.3%), and a second graft was necessary to achieve complete healing. The corneal epithelial defect healed in an average of 11.064.4 days after grafting. After PED resolution, the best-corrected visual acuity significantly improved from 0.6660.30 logMAR (20/91 Snellen) to 0.5860.24 logMAR (20/77 Snellen) (P¼0.036) compared with baseline. The AM resorbed within 2 weeks in all cases. No complication or recurrence was observed. Conclusions: A sutureless lyophilized AM under the BCL can resolve PEDs with a significant improvement in vision.

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Section: Discussionmentioning

confidence: 99%

“…More recently, commercially available dehydrated amnion tissue has been introduced, which can be easily stored and transported at room temperature. 14…”

mentioning

confidence: 99%

Sutureless Lyophilized Amniotic Membrane Grafting for Corneal Epithelial Defects

Delbarre

Boucenna

Froussart-Maille

2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…Patients were divided according to the cause of persistent corneal ulcer into four groups: group I, including 14 eyes with aqueous tear-deficient dry eye; group II, including six eyes post-keratoplasty (four eyes postpenetrating keratoplasty and two eyes post-deep anterior lamellar keratoplasty); group III, including four eyes with corneal chemical burn (three eyes with alkaline chemical burn and one eye with acidic chemical burn); and group IV, including 16 eyes with persistent corneal ulcer due to other causes, including post-fungal keratitis (Aspergillus fumigatus and Candida albicans), post-coronavirus disease (an episode of severe coronavirus disease and admission to the intensive care unit due to coronavirus disease-induced respiratory failure), post-cataract surgery, post-herpes simplex virus keratitis, limbal stem cell deficiency, corneal ulceration due to radiotherapy, and neurotrophic keratitis ( 191 persistent corneal ulcer was defined as a corneal epithelial defect with / without stromal defect persisting for at least 2 weeks without improvement in the size or depth despite standard treatment [16].…”

Section: Methodsmentioning

confidence: 99%

Safety and efficacy of eye drops from umbilical cord blood platelet lysate to treat resistant corneal ulcer

Farag¹,

Dawood²,

Elesawi³

2023

Med Hypothesis Discov Innov Ophthalmol

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Background: Umbilical cord blood (UCB) is a novel treatment of resistant corneal ulcers owing to the unique anti-inflammatory molecules and growth factors it contains. Platelet lysates are a potential future alternative. The aim of the present study was to assess the role of human UCB platelet lysate in treating resistant corneal ulcers. Methods: This was prospective, non-comparative, interventional case series involving 40 eyes of patients aged 6 – 65 years with persistent corneal ulcers from the Mansoura Ophthalmic Center and Mansoura Research Center for Cord Stem Cells. Patients were classified according to the cause of persistent corneal ulcer into four groups: group I, including 14 eyes with dry eye disease; group II, including six eyes post-keratoplasty; group III, including four eyes with corneal chemical burn; and group IV, including 16 eyes with persistent corneal ulcer from other causes. All participants underwent detailed ophthalmic examinations, and baseline and final best-corrected distance visual acuity (BCDVA) were recorded. Eye drops were prepared from UCB platelet lysate and administered to all patients along with detailed meticulous instructions for the method of use. Clinical progression of wound healing was continuously observed. The treatment response was identified as complete healing, improvement, or treatment failure. Results: BCDVA improved significantly in all studied groups (all P < 0.05). In group I, complete healing, improvement, and treatment failure occurred in 71%, 29%, and 0% of cases. In group II, complete healing, improvement, and treatment failure occurred in 67%, 33%, and 0% of cases. In group III, complete healing, improvement, and treatment failure occurred in 50%, 50%, and 0% of cases. In group IV, complete healing, improvement, and treatment failure occurred in 63%, 12%, and 25% of cases. No adverse events associated with the treatment were observed or subjectively self-reports in the study period. Conclusions: Eye drops from UCB platelet lysate were a novel therapeutic blood component with unique growth factors and anti-inflammatory compounds that could be an effective and safe treatment option in managing persistent corneal ulcers of different causes. A future randomized clinical trial with a large sample size and a longer follow-up is required to confirm these preliminary outcomes.

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“…Therefore, many techniques have been developed to preserve most of the biological properties of amniotic membranes by storage techniques and to prevent disease transmission to recipients [ 204 , 205 , 206 ]. In 2021, a cohort study from Queen Victoria Hospital and Maidstone Hospital showed that a dry and stable human amniotic membrane-derived matrix, Omnigen ® using OmniLenz ® (NuVision Therapies, Nottingham, UK), can easily be applied in the clinical setting with biochemical stability and efficiency as a novel tool to treat LSCD [ 207 , 208 ]. Based on the technique of dried amniotic membrane, Ting et al developed a modified ACER method by using low-temperature vacuum-dehydrated amniotic membrane instead of the cryopreserved amniotic membrane and fibrin glue rather than sutures [ 206 , 209 ].…”

Section: Therapy Of Lscdmentioning

confidence: 99%

Corneal Epithelial Stem Cells–Physiology, Pathophysiology and Therapeutic Options

Ruan

Jiang

Musayeva

et al. 2021

Cells

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In the human cornea, regeneration of the epithelium is regulated by the stem cell reservoir of the limbus, which is the marginal region of the cornea representing the anatomical and functional border between the corneal and conjunctival epithelium. In support of this concept, extensive limbal damage, e.g., by chemical or thermal injury, inflammation, or surgery, may induce limbal stem cell deficiency (LSCD) leading to vascularization and opacification of the cornea and eventually vision loss. These acquired forms of limbal stem cell deficiency may occur uni- or bilaterally, which is important for the choice of treatment. Moreover, a variety of inherited diseases, such as congenital aniridia or dyskeratosis congenita, are characterized by LSCD typically occurring bilaterally. Several techniques of autologous and allogenic stem cell transplantation have been established. The limbus can be restored by transplantation of whole limbal grafts, small limbal biopsies or by ex vivo-expanded limbal cells. In this review, the physiology of the corneal epithelium, the pathophysiology of LSCD, and the therapeutic options will be presented.

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Management of Persistent Corneal Epithelial Defects with Human Amniotic Membrane-derived Dry Matrix

Cited by 15 publications

References 33 publications

Sutureless Lyophilized Amniotic Membrane Grafting for Corneal Epithelial Defects

Sutureless Lyophilized Amniotic Membrane Grafting for Corneal Epithelial Defects

Safety and efficacy of eye drops from umbilical cord blood platelet lysate to treat resistant corneal ulcer

Corneal Epithelial Stem Cells–Physiology, Pathophysiology and Therapeutic Options

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