Fresh amniotic membrane transplantation for conjunctival surface reconstruction

Area of Science:

• Ophthalmology
• Regenerative Medicine
• Tissue Engineering

Background:

• Symblepharon, a severe complication of ocular surface disease, can lead to motility restriction and vision impairment.
• Conjunctival reconstruction is crucial for restoring ocular surface integrity and function.
• Human amniotic membrane (HAM) has shown promise as a biological substitute in ocular surface reconstruction.

Purpose of the Study:

• To evaluate the efficacy of fresh human amniotic membrane transplantation (AMT) for conjunctival reconstruction following symblepharon lysis.
• To compare the outcomes of fresh AMT versus preserved AMT in patients with severe symblepharon.

Main Methods:

• A randomized study involving 39 patients (42 eyes) with eye burns and Stevens-Johnson syndrome.
• Patients underwent symblepharon lysis followed by either fresh or preserved human amniotic membrane transplantation (AMT).
• Impression cytology was used to assess amniotic epithelial cell survival in a subset of patients.

Main Results:

• Successful ocular surface reconstruction and resolution of motility restriction were achieved in 37 eyes (35 patients) at a mean follow-up of 11 months.
• Minimal recurrence of symblepharon was observed in 5 eyes (4 patients), with no significant difference between fresh and preserved AMT groups.
• Amniotic epithelial cells demonstrated survival for approximately three months on ocular surfaces with normal tear secretion.

Conclusions:

• Both fresh and preserved human amniotic membrane are effective substrates for conjunctival reconstruction during severe symblepharon lysis.
• AMT offers a viable and successful alternative for restoring ocular surface integrity in challenging cases.
• The study supports the use of AMT as an ideal option for managing severe symblepharon.