Amniotic membrane transplantation in entropion surgery

Area of Science:

• Ophthalmology
• Regenerative Medicine

Background:

• Cicatricial entropion, a severe eyelid malformation, can lead to significant visual impairment.
• Current management strategies often involve complex surgical reconstructions.

Purpose of the Study:

• To evaluate the efficacy of amniotic membrane transplantation (AM) in conjunction with a lid split procedure for cicatricial entropion.
• To assess the impact of AM on tarsal epithelialization, shrinkage, and recurrence rates.

Main Methods:

• A prospective, noncomparative interventional case series involving 18 patients with cicatricial entropion.
• A gray line lid split procedure with vertical anterior lamella repositioning was performed on 25 eyelids, utilizing preserved human amniotic membrane (AM) to cover the bare tarsus.
• Impression cytology was used to study the epithelialization process of the AM graft.

Main Results:

• Amniotic membrane (AM) grafts demonstrated successful integration in all cases, with hemorrhage below the graft as the most common complication.
• Complete success, defined as no lashes touching the globe, was achieved in 88% of eyelids after a mean follow-up of 17.8 months.
• AM accelerated bare tarsus epithelialization within 2-3 weeks but did not prevent tarsal shrinkage. Impression cytology revealed conjunctival epithelium replaced by squamous metaplasia and keratinization over time.

Conclusions:

• Amniotic membrane transplantation, when used with a lid split procedure for cicatricial entropion, facilitates rapid epithelialization of the bare tarsus.
• This approach improves the initial cosmetic results of the surgery and offers a high success rate in correcting the condition.