Controversies and Limitations of Amniotic Membrane in Ophthalmic Surgery

Low oxygen tension and macromolecular crowding accelerate extracellular matrix deposition in human corneal fibroblast culture

“…Although amniotic membranes have been used effectively in clinical setting (Nishida K ; Muqit MM and Ellingham RB and Daniel C ; Nubile M and Dua HS and Lanzini TE‐M and Carpineto P and Ciancaglini M and Toto L and Mastropasqua L ), several drawbacks, such as infections, batch‐to‐batch variations, lack of standardisation, calcification, granulomatous reaction and early detachment after transplantation, have limited their use (Dua HS and Maharajan VS and Hopkinson A ; Rahman I and Said DG and Maharajan VS and Dua HS ; Malhotra C and Jain A ). To this end, natural (Alaminos M and Sánchez‐Quevedo MDC and Muñoz‐Ávila JI and Serrano D and Medialdea S and Carreras I and Campos A ; Liu W and Merrett K and Griffith M and Fagerholm P and Dravida S and Heyne B and Scaiano JC and Watsky MA and Shinozaki N and Lagali N and Munger R and Li F ; Lawrence BD and Marchant JK and Pindrus MA and Omenetto FG and Kaplan DL ; Calderón‐Colón X and Xia Z and Breidenich J and Mulreany D and Guo Q and Uy O and Tiffany J and Freund D and McCally R and Schein O and Elisseeff J and Trexler M ; Espandar L and Bunnell B and Wang GY and Gregory P and McBride C and Moshirfar M ; Koh L and Islam M and Mitra D and Noel C and Merrett K and Odorcic S and Fagerholm P and Jackson W and Liedberg B and Phopase J and Griffith M ; Gouveia RM and Jones RR and Hamley IW and Connon CJ ; Xiao X and Pan S and Liu X and Zhu X and Connon CJ and Wu J and Mi S ) and synthetic (Wathier M and Johnson C and Kim T and Grinstaff M ; Degoricija L and Johnson C and Wathier M and Kim T and Grinstaff M ; Grinstaff M ; Garagorri N and Fermanian S and Thibault R and Ambrose WM and Schein OD and Chakravarti S and Elisseeff J ; Berdahl J and Johnson C and Proia A and Grinstaff M and Kim T ; Hartmann L and Watanabe K and Zheng L and Kim C and Beck S and Huie P and Noolandi J and Cochran J and Ta C and Frank C ; Deshpande P and Ramachandran C and Sangwan V and Macneil S ; Wu JW and Du Y and Mann MM and Yang E and Funderburgh JL and Wagner WR ) biomaterials, loaded with appropriate biological / therapeutic molecules and / or cell populations, have extensively used with promising results to‐date with respect to cell growth, mechanical stability and optical transparency.…”

Amniotic Membrane for Ocular Surface Reconstruction: Donor Variations and the Effect of Handling on TGF-β Content

“…Despite its widespread use, the characteristics of the membrane that is procured, supplied, and applied to patients is far from standardized. 6 The effect of handling on the membrane is unknown. In addition, little is known of the interdonor and intradonor variability within the membrane.…”

“…Some of the variability in clinical outcomes that has been reported after the use of the membrane could well be related to such differences. 1,6 One of the major reported properties attributed to AM is its ability to facilitate wound healing, [7][8][9] which is associated with the action of TGF-␤. Three highly conserved isoforms of mammalian TGF-␤ (TGF-␤1, TGF-␤2, and TGF-␤3) 10 are encoded by distinct genes.…”

Amniotic membrane transplantation for ocular surface reconstruction: indications and outcomes

“…It is not common practice to indicate with the membrane, the weeks of gestation or whether trial of labour was given before caesarean section. Many changes in the biochemical composition of the membrane are known to occur nearer term and to be induced by labour, for example, increased apoptosis of amnion epithelial cells just before commencement of labour and increased interleukin‐6 and interleukin‐8 concentrations in the amniotic fluid towards the end of pregnancy 31,32 …”