Reconstruction with umbilical amnion following ocular evisceration: A case study

Clinical use of cryopreserved ultra-thick human amniotic membrane for anophthalmic socket contracture

“…Amnion is an ideal tissue for wound healing as it promotes epithelialization, contains mesenchymal stem cells, and has anti-inflammatory and anti-fibrotic properties. 26 Amnion consists of a cuboidal epithelium, a basement membrane, and a mesenchymal stroma consisting of compact, fibroblast, and spongy layers. The amniotic epithelial cells contain growth factors such as basic fibroblast, epidermal, and keratinocyte growth factors that promote epithelialization, inhibit angiogenesis, inhibit fibroblast activation, inhibit the innate and adaptive immune arcs, and promote neural differentiation.…”

“…The amniotic epithelial cells contain growth factors such as basic fibroblast, epidermal, and keratinocyte growth factors that promote epithelialization, inhibit angiogenesis, inhibit fibroblast activation, inhibit the innate and adaptive immune arcs, and promote neural differentiation. 26 The use of placental amnion has been discussed as a graft material for management of anophthalmic socket contracture with a comparable success rate to mucous membrane grafts. However, the placental amnion is fragile in nature which is less than desirable for managing conditions that need strong tensile like support of ocular prosthesis.…”

A Review of Current Uses of Amniotic Membrane Transplantation in Ophthalmic Plastic and Reconstructive Surgery

“…Autografting healthy conjunctiva from the same or fellow eye or oral mucosa can cause donor site morbidity and the supply of tissue can be limited. 32 Amniotic membrane has been suggested to improve conjunctival growth in cases of dermis fat graft or orbital implant exposure particularly when conjunctival tissue is limited. 34 In patients with exposed hydroxyapatite or Medpor implants, fresh frozen amniotic membrane sutured into place successfully closed the defect at a follow-up of several months in all 10 described cases.…”

“…[29][30][31] In a patient with conjunctival wound dehiscence after evisceration, an ultra-thick graft was able to cover the defect and expand the fornices, allowing for good prosthetic fitting at follow-up 8 months later. 32 In more advanced cases with ischemic tissue, the defect may be more difficult to close with the amniotic membrane because the graft relies on having healthy adjacent tissue to re-epithelialize the conjunctiva. 29 Ultra-thick AMT may be beneficial in more advanced cases due to the increased thickness of the graft.…”

“…Autografting healthy conjunctiva from the same or fellow eye or oral mucosa can cause donor site morbidity and the supply of tissue can be limited. 32 Amniotic membrane has been suggested to improve conjunctival growth in cases of dermis fat graft or orbital implant exposure particularly when conjunctival tissue is limited. 34…”