Mitomycin and Amniotic Membrane: A New Method of Reducing Adhesions and Fibrosis in Strabismus Surgery

Abstract

The effectiveness of complex strabismus surgery is often limited by the development of fibrosis postoperatively. The use of mitomycin C to reduce fibrosis in strabismus surgery has been reported, but the use of amniotic membrane has not. We describe a technique which uses both mitomycin C and amniotic membrane patches to reduce fibrosis. We describe this technique for two patients with complex strabismus who were treated with this technique.

Age Does Matter: A Pilot Comparison of Placenta-Derived Stromal Cells for in utero Repair of Myelomeningocele Using a Lamb Model

“…We previously demonstrated that use of a fetal amniotic membrane (FM) patch improved preservation of normal spinal cord histology in the fetal sheep model of MMC; however, the patch was also shown to interfere with wound healing [2]. Given the known anti-inflammatory and epithelialization-promoting properties of the fetal membranes [3,4,5,6,7,8], we continued to believe that there was promise for FM repair for MMC. Recent literature has shown that the placenta is also a source of cells that have remarkable immunomodulatory properties, can improve wound healing, and exhibit neuroprotective effects [9,10,11,12,13].…”

In utero repair of myelomeningocele with autologous amniotic membrane in the fetal lamb model

“…These properties have led to its use in diverse surgical settings, including ophthalmology and wound care [3][4][5][6][7][8][9][10]. Based on anecdotal experience and extensive literature supporting the anti-inflammatory and epithelialization-promoting properties of AM, we hypothesized that the use of autologous AM during in utero MMC repair would provide improved protection to the spinal cord.…”

Amniotic membrane in the management of strabismus reoperations

“…Amniotic membrane in strabismus 243 AM in complicated strabismus cases presented case reports or case series instead of control group studies [11][12][13]. The results of the previous experimental and clinical studies and those of our study suggest that there may be a role for AM in the management of strabismus reoperations [26].…”

“…Yamada et al published a case report on the successful treatment of restrictive strabismus occurring after retinal detachment surgery, Sheha et al described wrapping the extraocular muscles (EOM) with AM in a case of consecutive exotropia, and Kersey and Vivian used AM in conjunction with mitomycin C in two patients with complex strabismus surgery [10][11][12]. Strube et al reported a case series describing the use of AM transplant to repair restrictive strabismus occurring after a variety of anterior segment, oculoplastic and retinal surgeries [13].…”