Safety and efficacy of human amniotic membrane in primary pterygium surgery

Marsit, Nagi M.; Gafud, Nagmeden; Kafou, Inass; Mabrouk, Achraf; Alatiweel, Aml; Abdalla, Sedigh; Sheghewi, Lamia

doi:10.1007/s10561-016-9554-9

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…e postoperative recurrence rate is close to that of conjunctival transplantation. If some pathological tissue remains after operation, it may still use amniotic membrane for proliferation and migration, and then form recurrent pterygium [20][21][22]. In conclusion, incomplete resection of degenerative conjunctiva and its underlying tissues, slow recovery of limbal stem cells in the damaged area, chronic conjunctival inflammation, and persistent congestion in the operation area are the reasons for the increase of postoperative recurrence rate [23,24].…”

Section: Discussionmentioning

confidence: 99%

[Retracted] Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium

Chen

Zheng

Zhang

et al. 2022

Contrast Media & Molecular Imaging

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Objective. The aim of the study is to evaluate the safety and effectiveness of amniotic membrane transplantation combined with the closure of the tenon capsule and bulbar conjunctival space. Methods. This study retrospectively included 100 patients with primary pterygium who received closed bulbar conjunctiva and tenon capsule space combined with amniotic membrane transplantation in our hospital from January 2020 to June 2021 as the experimental group and 100 patients with routine treatment in the same period as the control group. The postoperative efficacy evaluation and postoperative complications of the two groups were compared, so as to comprehensively evaluate the safety and effectiveness of this method. Results. The results showed that the postoperative complications of the two groups were significantly improved by Fisher’s exact test (χ2 = 14.510, P = 0.006 < 0.05). The comparison results showed that the treatment group showed significant advantages in six indexes compared with the observation group and the difference between the two groups was statistically significant (P < 0.05) of in the NRS score, Prabhasawat score, inspection of the ocular surface comprehensive analyzer, corneal fluorescein staining, conjunctival fluorescein staining in the operation area, breakup time of tear film examination of the two groups at 3, 7 and 14 days, and 1, 6 and 12 months after the operation. Conclusions. Amniotic membrane transplantation combined with the closure of the tenon capsule and bulbar conjunctival space is safer than conventional surgery in the treatment of primary pterygium. It has a shorter recovery time, higher safety, and a positive curative effect. It can be considered to popularize this operation in clinic.

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Section: Discussionmentioning

confidence: 99%

[Retracted] Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium

Chen

Zheng

Zhang

et al. 2022

Contrast Media & Molecular Imaging

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“…Subsequent preservation via heat, freeze-drying, or deep freezing at below −60 °C are applied to suppress water activity to maintain tissue stability, and prevent microbial growth. However, to address bioburden contamination, antibiotics are typically added to the collection medium or storage medium for frozen AM 20,21 . For dried AM products, vacuum-packing followed by radiation sterilisation is often applied to ensure complete microbial inactivity 22 .…”

Section: Introductionmentioning

confidence: 99%

Validation and assessment of an antibiotic-based, aseptic decontamination manufacturing protocol for therapeutic, vacuum-dried human amniotic membrane

Marsit

Sidney

Britchford

et al. 2019

Sci Rep

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Amniotic membrane (AM) is used to treat a range of ophthalmic indications but must be presented in a non-contaminated state. AM from elective caesarean sections contains natural microbial contamination, requiring removal during processing protocols. The aim of this study was to assess the ability of antibiotic decontamination of AM, during processing by innovative low-temperature vacuum-drying. Bioburden of caesarean section AM was assessed, and found to be present in low levels. Subsequently, the process for producing vacuum-dried AM (VDAM) was assessed for decontamination ability, by artificially loading with Staphylococcus epidermidis at different stages of processing. The protocol was highly efficient at removing bioburden introduced at any stage of processing, with antibiotic treatment and drying the most efficacious steps. The antibacterial activity of non-antibiotic treated AM compared to VDAM was evaluated using minimum inhibitory/biocidal concentrations (MIC/MBC), and disc diffusion assays against Meticillin-resistant Staphylococcus aureus , Meticillin-resistant S . epidermidis , Escherichia coli , Pseudomonas aeruginosa and Enterococcus faecalis . Antibacterial activity without antibiotic was low, confirmed by high MIC/MBC, and a no inhibition on agar lawns. However, VDAM with antibiotic demonstrated effective antibacterial capacity against all bacteria. Therefore, antibiotic decontamination is a reliable method for sterilisation of AM and the resultant antibiotic reservoir is effective against gram-positive and –negative bacteria.

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“…Earlier studies on the use of amniotic membrane for primary pterygium reported a high recurrence rate of >60%, 10 whereas later studies yielded more acceptable recurrence rates between 13.8% and 18.6% at 6 to 12 months after excision of primary pterygium. 11,12 Clearfield et al systematically reviewed 20 randomized controlled trials containing >1900 eyes, and concluded that amniotic membrane was inferior to conjunctival autograft in preventing pterygium recurrence. 13…”

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confidence: 99%

Pterygium: Surgical Techniques and Choices

Young

Kam

2019

Asia-Pacific Journal of Ophthalmology

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P terygium is known to exist for >3000 years. Ancient Egyptians and Greeks applied potions of various chemicals to the ocular surface as an attempt to eradicate the lesion. The first documentation of a surgical excision was around 500 to 1000 BC (by Susruta), similar to the bare sclera excision of today. This was followed by application of an ointment to prevent recurrence. 1 The concept of recurrence after pterygium removal is known to us for a long time. Despite advancements in surgical instrumentation, microscopes, suturing materials and medications, and also techniques developed, studied and tried in clinical research worldwide, recurrence of pterygium is still of concern several millennia later. The "ideal technique" with the least risks of recurrence and best side-effects profile remains elusive.Phathanthurarux and Chantaren 2 conducted a survey across Thailand and reviewed the perspectives and practices of ophthalmologists in their country. They set out to identify the important barriers, explore the ideal practice, and study the underlying factors driving these practices. In their questionnaire with >400 respondents, the most practiced methods were the bare sclera technique and conjunctival autograft in primary and recurrent pterygia. In both types of pterygia, the majority of respondents indicated that they would not consider adjuvant therapy, which was attributed to concerns regarding the potential complications and overall inexperience with the surgical techniques. Phathanthurarux and Chantaren also highlighted issues on the lack of accessibility to or availability of amniotic membranes and the relative high cost of fibrin glue (of relevance in the context for less affluent economies or practices in the Asia-Pacific region). In their survey, recurrence of pterygium was the most common late postoperative complication, reported by over three quarters of the respondents. Although the study did not directly measure the actual recurrence rates, the high number of respondents encountering recurrence was in line with earlier reports of similarly high recurrence rates expected in primary pterygium excision with bare sclera techniques. 3 During the past millennia, ophthalmologists sought after the ideal method of managing both primary and recurrent pterygia. The most commonly employed techniques would include the various conjunctival grafting with or without limbal tissue, 4-6 fixated with either absorbable or nonabsorbable sutures, fibrin glue or even autologous blood or fibrin. 7,8 Beta-irradiation is seldom if at all being practised nowadays, whereas antimetabolites such as mitomycin-C (MMC) and 5-fluorouracil had gained popularity in comparison. Various modes of applications have been used, either intraoperatively as a single dose or postoperatively as subconjunctival injections or drops, adopting different concentrations and durations of treatment. MMC used in conjunction with tissue grafts in randomized, controlled studies would lower pterygium recurrences. 9 However, concerns regarding the potential comp...

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Safety and efficacy of human amniotic membrane in primary pterygium surgery

Cited by 7 publications

References 25 publications

[Retracted] Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium

[Retracted] Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium

Validation and assessment of an antibiotic-based, aseptic decontamination manufacturing protocol for therapeutic, vacuum-dried human amniotic membrane

Pterygium: Surgical Techniques and Choices

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