Amniotic Membrane Transplantation in Reconstructive and Regenerative Ophthalmology

Abstract

BackgroundThe goal of this study was to investigate numbers, indications, surgical techniques, and experiences of amniotic membrane transplantation at the University Eye Hospital Tübingen over the last 16 years.Material/MethodsData from all amniotic membrane transplantations from January 2001 to December 2016 were retrospectively analyzed. Data was accessed from the electronic database and the annual reports of the Eye Bank at the University Eye Hospital Tübingen.ResultsA total of 771 amniotic membrane transplantations were performed between 2001 and 2016 at the University Eye Hospital Tübingen. The mean number of amniotic membrane transplantations was 48 per year (range: 7–81). Overall, the mean number of amniotic membrane transplantations more than doubled, from 31 amniotic membrane transplantations per year during the first 8-year period to 66 amniotic membrane transplantations per year during the second 8-year period (p<0.0001). The most common surgical indications for amniotic membrane transplantation were corneal ulcers and persistent corneal epithelial defects. The inlay, overlay, and sandwich technique became the favored surgical methods for various disorders of the ocular surface.ConclusionsOur study showed a significant increase of amniotic membrane transplantations from 2001 to 2016. This increase is likely influenced by the introduction of different surgical amniotic membrane transplantation techniques, the rising knowledge about containing growth factors, neurotrophins and cytokines, and the demographic change with aging of the population.

Ophthalmic use of amniotic membrane tissue in Australia: Introduction and initial use of a service

“…Requests have been received and completed from 58 ophthalmic surgeons across all states and territories except Northern Territory suggesting a basic national demand for AM. Fifty‐nine percent of recipients were male with a mean age of 64.0 ± 17.3 years (range 6 to 93) corresponding with population findings from the existing ophthalmic literature . Seven patients required multiple tissue applications for surface reconstruction or tectonic repair (neoplasia, corneal ulcer at risk of perforation, infectious scleritis and alkali burn).…”

“…Amniotic membrane (AM) has been used across ophthalmology for almost 80 years . AM has been shown to stimulate wound repair while suppressing inflammation, angiogenesis and scarring offering potential opportunities for the successful treatment of an increasing number of ophthalmic indications . Essential for use in ocular surgery, the tissue is non‐reactive and largely transparent .…”

“…Although AM transplantation within ophthalmology has significant potential, it is not without limitations . Continued monitoring of surgical and post‐operative outcomes is essential, especially in a developing service.…”

Preparation of placental tissue transplants and their application in skin wound healing and chosen skin bullous diseases ‐ Stevens‐Johnson syndrome and toxic epidermal necrolysis treatment

“…7,[59][60][61] Amniotic membrane is commonly used with very good clinical effects in eye ulcerations, eye burns or corneal epithelial defects. [62][63][64][65] Moreover, its high efficacy was shown in patients after pterygium extended removal. This surgical removal was followed by fibrin glue-assisted amniotic membrane transplantation, which resulted in low complication rate, low recurrence rate and high cosmetic satisfaction found during postoperative follow up.…”

Surgical management of a conjunctival nevus with amniotic membrane transplantation

“…In recent years, AMTs have been used increasingly and successfully to treat, manage, and reconstruct various types of ophthalmic conditions, which include particularly persistent corneal epithelial defects, corneal ulcers, and conjunctival defects after the resection of lesions. 5 The amniotic membrane (AM) has wide clinical applications in various fields of medicine, because it contains abundant growth factors and anti-inflammatory proteins, promotes epithelialization, inhibits fibrosis, and suppresses inflammation and bacterial growth. 6 – 8 AMs have already been used as biological dressings in abdominal surgery, genital reconstruction, oral and periodontal procedures, and plastic surgery.…”