Adhesion of Regenerating Corneal Epithelium

Khodadoust, Ali A.; Silverstein, Arthur M.; Kenyon, Kenneth R.; Dowling, John E.

doi:10.1016/0002-9394(68)93082-1

Cited by 244 publications

(71 citation statements)

References 4 publications

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“…The characteristics that promote epithelialization of the amniotic membrane itself also may contribute. [26][27][28] The speed with which the wounds healed agreed with those reported previously. Oh and Kim 29 reported that epithelialization of the scleral surface occurred in 1 week when they used amniotic membrane in seven of eight patients with scleromalacia.…”

Section: Discussionsupporting

confidence: 89%

Surgical treatment of necrotic scleral calcification using combined conjunctival autografting and an amniotic membrane inlay filling technique

2011

Eye

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Purpose To introduce a novel technique to treat necrotic scleral calcification caused by previous regional conjunctivectomy using conjunctival autografting and amniotic membrane inlay filling, and to evaluate the clinical outcome. Methods Ten patients (11 eyes, 12 regions) who had undergone regional conjunctivectomy with postoperative mitomycin C (MMC) for pterygia or pingueculae were included. Scleral calcification was removed using a bevel-down crescent knife. After the conjunctival donor tissue was harvested from the upper bulbar conjunctiva, the tissue was grafted to the scleral defect and secured with sutures. Amniotic membrane was inserted randomly into spaces between the conjunctival graft and the scleral bed. Protective amniotic membrane was transplanted over the graft, with stromal side up. Results Scleral calcification developed in ischaemic areas in 11 of the 12 regions; 50% of cases had a surface defect seen with a fluorescent dye. The grafted conjunctiva epithelialized successfully in all cases. In 10 regions, the epithelialization occurred in 1 or 2 weeks. In the remaining two regions, one region required another surgery because of graft failure, and epithelialization occurred in the last region in 9 weeks. Vascular growth into the graft from the surrounding tissue occurred in all cases in 1 to 10 weeks. The surgical wound stabilized 3 weeks postoperatively. ConclusionThe combined technique had high success rates of graft survival and good revitalization of the necrotic area of scleral calcification, eliminated the need for invasive and time-consuming scleral autografting or allografting, and provided good cosmesis. Scleral ischaemia, which was caused by MMC, may induce scleral calcification.

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Section: Discussionsupporting

confidence: 89%

Surgical treatment of necrotic scleral calcification using combined conjunctival autografting and an amniotic membrane inlay filling technique

2011

Eye

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“…Studies suggest the beneficial features of promoting epithelialization and inhibiting inflammation and fibrosis. 13 AM may provide a basement membrane rich in various growth factors and matrix proteins, 14 which promotes epithelial cell migration, 15 adhesion, 16 and differentiation. 17,18 AM is also believed to have anti-inflammatory 19,20 and antifibrotic effects.…”

Section: Discussionmentioning

confidence: 99%

Comparison of de-epithelialized amniotic membrane transplantation and conjunctival autograft after primary pterygium excision

Memarzadeh

Fahd

Shamie

et al. 2006

Eye

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Purpose To study the efficacy of deepithelialized amniotic membrane (AM) graft (AmbioDry, Okto Ophtho Inc., Costa Mesa, CA, USA) as an adjunctive therapy after primary pterygium excision in comparison to standard conjunctival autograft. Methods A retrospective review of 23 eyes of 22 patients receiving pterygium excision followed by AM transplantation was performed. The results were compared retrospectively with 40 eyes of 36 patients receiving conjunctival autograft after pterygium excision. All patients were Hispanic. Recurrence was defined as regrowth of fibrovascular tissue over the corneoscleral limbus onto clear cornea in the area of previous pterygium excision. Results The pterygium recurrence rates after AM graft and conjunctival autograft were 35 and 25%, respectively. There was no significant difference in recurrence rate between the two groups (P ¼ 0.56). The mean follow-up period was 5.972.4 months. No major complications were noted in either group. Conclusion This study provides preliminary evidence that de-epithelialized AM graft is as effective as conjunctival autograft in preventing pterygium recurrence in this Southern California Hispanic population.

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“…Reattachment of corneal epithelium following an initial abrasion appears to be faulty in RCE. 19,20 In RCE, a variety of adhesion complex defects have been observed that include: reduplication of BM, loculation of connective tissues, absence of BM and hemidesmosomes. [20][21][22] The corneal epithelium may contain pale, swollen basal epithelial cells.…”

Section: Pathological Anatomymentioning

confidence: 99%

Pathogenesis, clinical features and management of recurrent corneal erosions

Ramamurthi

Rahman

Dutton

et al. 2005

Eye

113

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Recurrent corneal erosions (RCE) are common. They are characterised by repeated episodes of pain, difficulty in opening the eyes, watering, and photophobia resulting from poor epithelial adhesion. In the majority of patients with RCE, trauma is the initiating factor. Epithelial, stromal, and endothelial corneal dystrophies have all been described in association with RCE. Other causes that may lead to RCE include chemical and thermal injuries, previous herpetic keratitis, meibomian gland dysfunction, ocular rosacea, diabetes mellitus, Salzmann's nodular degeneration, band keratopathy, previous bacterial ulceration, kerato-conjunctivitis sicca, and epidermolysis bullosa. The conditions that are associated with RCE can be either primary or secondary depending on whether the basement membrane complex abnormality is intrinsic or acquired. Primary types tend to be bilateral, symmetrical and develop in multiple corneal locations. The pathogenetic mechanism of this disorder is related to poor adhesion of the corneal epithelium to the underlying stroma. Excessive matrix metalloproteinase (MMP) activity may play a role in the pathogenesis. Although the majority of patients will respond to simple measures such as padding and antibiotic ointment, RCE resistant to simple measures require approaches that are more elaborate. The common goal of these approaches is to encourage proper formation of adhesion complexes between the epithelium and the stroma. The use of longterm contact lenses, autologous serum eye drops, botulinum toxin, induced ptosis, oral MMP inhibitors, diamond burr polishing of Bowman's membrane have been reported with varying degree of success in treating RCE. Anterior stromal puncture with insulin needles or Neodymium : aluminium-yttriumgarnet may enhance the epithelial adhesion to the basement membrane by scar formation and success rates of up to 80% have been reported in the treatment of recalcitrant RCE. Excimer laser photo-therapeutic keratectomy (PTK) is now a well-established treatment modality for RCE and is being used both safely and effectively. Partial ablation of Bowman's layer with PTK gives a smooth surface for the newly generating epithelium to migrate and form adhesion complexes. The pathogenesis, clinical features, and management options of this common disorder are discussed in this review article.

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Adhesion of Regenerating Corneal Epithelium

Cited by 244 publications

References 4 publications

Surgical treatment of necrotic scleral calcification using combined conjunctival autografting and an amniotic membrane inlay filling technique

Surgical treatment of necrotic scleral calcification using combined conjunctival autografting and an amniotic membrane inlay filling technique

Comparison of de-epithelialized amniotic membrane transplantation and conjunctival autograft after primary pterygium excision

Pathogenesis, clinical features and management of recurrent corneal erosions

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