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Sanders FWB, Huang J, Alió Del Barrio JL, Hamada S, McAlinden C. Amniotic membrane transplantation: structural and biological properties, tissue preparation, application and clinical indications. Eye (Lond) 2024; 38:668-679. [PMID: 37875701 PMCID: PMC10920809 DOI: 10.1038/s41433-023-02777-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 07/20/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
The amniotic membrane is a single epithelial layer of the placenta. It has anti-inflammatory, anti-scarring, anti-angiogenic and possibly bactericidal properties. The basement membrane of the amniotic membrane acts as a substrate to encourage healing and re-epithelialisation. It has been used in many ocular surface diseases including persistent epithelial defects (corneal or conjunctival), chemical or thermal burns, limbal stem cell deficiency, cicatrising conjunctivitis, ocular graft versus host disease, microbial keratitis, corneal perforation, bullous keratopathy, dry eye disease, corneal haze following refractive surgery and cross-linking, band keratopathy, ocular surface neoplasia, pterygium surgery, and ligneous conjunctivitis. This review provides an up-to-date overview of amniotic membrane transplantation including the structural and biological properties, preparation and application, clinical indications, and commercially available products.
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Affiliation(s)
- Francis W B Sanders
- Department of Ophthalmology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Jinhai Huang
- Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Jorge L Alió Del Barrio
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain; and Cornea, Cataract and Refractive Surgery Department, VISSUM Corporation, Alicante, Spain
| | - Samer Hamada
- Corneo Plastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK
| | - Colm McAlinden
- Eye and ENT Hospital, Fudan University, Shanghai, China.
- Corneo Plastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK.
- School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cardiff, UK.
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Lohchab M, Gour A. Letter Regarding: Why Are Corneal Specialists Resistant to Treating Patients Who Have Severe Ocular Surface Disease with Limbal Stem Cell Deficiency? Cornea 2024; 43:e1. [PMID: 37824195 DOI: 10.1097/ico.0000000000003410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Affiliation(s)
- Monica Lohchab
- Dr Shroff's Charity Eye Hospital, Daryaganj, Delhi, India
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Sonntag R, Kassumeh S, Luft N, Priglinger SG, Mayer WJ. [Allogeneic simple limbal epithelial transplantation (alloSLET)-Treatment of bilateral limbal stem cell insufficiency]. DIE OPHTHALMOLOGIE 2023; 120:1276-1278. [PMID: 37071184 DOI: 10.1007/s00347-023-01849-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/20/2023] [Accepted: 03/15/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Ruven Sonntag
- Augenklinik und Poliklinik, Klinikum der Universität München, Mathildenstr. 8, 80336, München, Deutschland
| | - Stefan Kassumeh
- Augenklinik und Poliklinik, Klinikum der Universität München, Mathildenstr. 8, 80336, München, Deutschland
| | - Nikolaus Luft
- Augenklinik und Poliklinik, Klinikum der Universität München, Mathildenstr. 8, 80336, München, Deutschland
- Auge-Laser-Chirurgie, Linz, Österreich
| | - Siegfried G Priglinger
- Augenklinik und Poliklinik, Klinikum der Universität München, Mathildenstr. 8, 80336, München, Deutschland
- Auge-Laser-Chirurgie, Linz, Österreich
| | - Wolfgang J Mayer
- Augenklinik und Poliklinik, Klinikum der Universität München, Mathildenstr. 8, 80336, München, Deutschland.
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Corneal Epithelial Regeneration: Old and New Perspectives. Int J Mol Sci 2022; 23:ijms232113114. [DOI: 10.3390/ijms232113114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022] Open
Abstract
Corneal blindness is the fifth leading cause of blindness worldwide, and therapeutic options are still often limited to corneal transplantation. The corneal epithelium has a strong barrier function, and regeneration is highly dependent on limbal stem cell proliferation and basement membrane remodeling. As a result of the lack of corneal donor tissues, regenerative medicine for corneal diseases affecting the epithelium is an area with quite advanced basic and clinical research. Surgery still plays a prominent role in the treatment of epithelial diseases; indeed, innovative surgical techniques have been developed to transplant corneal and non-corneal stem cells onto diseased corneas for epithelial regeneration applications. The main goal of applying regenerative medicine to clinical practice is to restore function by providing viable cells based on the use of a novel therapeutic approach to generate biological substitutes and improve tissue functions. Interest in corneal epithelium rehabilitation medicine is rapidly growing, given the exposure of the corneal outer layers to external insults. Here, we performed a review of basic, clinical and surgical research reports on regenerative medicine for corneal epithelial disorders, classifying therapeutic approaches according to their macro- or microscopic target, i.e., into cellular or subcellular therapies, respectively.
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Al-Ghadeer H, Al Amry M, Aldihan KA, Alobaidan OS, AlQahtani GMS, Khandekar R. Demographic, Clinical Profile and Management Outcomes of Ocular Chemical Injuries in Saudi Children. Clin Ophthalmol 2022; 16:3247-3255. [PMID: 36211717 PMCID: PMC9534152 DOI: 10.2147/opth.s379081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Huda Al-Ghadeer
- Emergency Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Correspondence: Huda Al-Ghadeer, Emergency Department, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh, 11462, Saudi Arabia, Tel +966 1 4821234 ext. 2500, Email
| | - Mohammed Al Amry
- Emergency Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Khalid A Aldihan
- Ophthalmology Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Omar S Alobaidan
- Ophthalmology Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Rajiv Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Corneal stromal repair and regeneration. Prog Retin Eye Res 2022; 91:101090. [DOI: 10.1016/j.preteyeres.2022.101090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 01/02/2023]
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Ten Years of Pediatric Ocular Chemical Burn Experience in a Tertiary Eye Care Center in Turkey. Eye Contact Lens 2021; 48:175-179. [DOI: 10.1097/icl.0000000000000858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 12/09/2022]
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Prabhasawat P, Chirapapaisan C, Ngowyutagon P, Ekpo P, Tangpagasit W, Lekhanont K, Sikarinkul R, Matamnan S, Boonwong C, Pinitpuwadol W, Thamphithak R, Sukon N, Neti N. Efficacy and outcome of simple limbal epithelial transplantation for limbal stem cell deficiency verified by epithelial phenotypes integrated with clinical evaluation. Ocul Surf 2021; 22:27-37. [PMID: 34214675 DOI: 10.1016/j.jtos.2021.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the efficacy and outcome of simple limbal epithelial transplantation (SLET) for limbal stem cell deficiency (LSCD) using epithelial phenotype detection integrated with clinical manifestation. METHODS This prospective multicenter study included patients with LSCD who underwent autologous SLET (autoSLET) and living-related allogenic SLET (Lr-alloSLET). All patients were assessed by slit-lamp biomicroscopy, in vivo confocal microscopy (IVCM), and impression cytology with immunofluorescence staining (ICIF) before and after surgery. The criteria for success were the presence of a clinically non-conjunctivalized cornea and corneal epithelium detected by IVCM or ICIF. Otherwise, the case would be considered a failure. Visual improvement and risk factors for SLET failure were analyzed. RESULTS A total of 28 eyes of 26 patients (11 autoSLET and 17 Lr-alloSLET) were included. The median age was 53 years (range, 35-63), and the follow-up time was 29.5 months (range, 17.5-39.8). The overall survival rate was 89.3% at 2 years and 75.6% at 3 years with no difference between autoSLET and Lr-alloSLET (p = 0.24). Seven eyes subsequently underwent penetrating keratoplasty. Immunohistochemistry analysis showed that all corneal buttons had corneal epithelium and limbal stem cell markers. Visual improvement was achieved in both SLET groups (p < 0.001). Failed SLET developed between 5 and 32 months postoperatively. However, absolute risk factors for SLET failure were unidentified. CONCLUSION The efficacy of autoSLET and Lr-alloSLET for LSCD was excellent. Limbal explants can regenerate and restore the corneal surface while maintaining the characteristics of limbal stem cells as shown by epithelial phenotype detection and immunohistochemistry integrated with clinical evaluation.
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Affiliation(s)
- Pinnita Prabhasawat
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chareenun Chirapapaisan
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Panotsom Ngowyutagon
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pattama Ekpo
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wimolwan Tangpagasit
- Department of Ophthalmology, Faculty of Medicine, Thammasat University, Prathumthani, Thailand
| | - Kaevalin Lekhanont
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Rosanun Sikarinkul
- Department of Ophthalmology, Golden Jubilee Medical Center, Mahidol University, Thailand
| | - Sutthicha Matamnan
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chawikan Boonwong
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Warinyupa Pinitpuwadol
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ranida Thamphithak
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nutchaya Sukon
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nutnicha Neti
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Abstract
Purpose: To review the surgical management options in ocular chemical burn, including newer advances.Methods: Online literature search of published articles over last 5 years on surgical management of ocular chemical burn and newer advances were performed on December 30, 2020.Results: Following literature search and screening using adequate filters, 67 review articles on surgical management of ocular chemical burns were retrieved. The review talks about the surgical management options starting from Debridement in acute stage to various visual rehabilitative procedures in the chronic stage. The review also highlights the evolving surgical advances in this field.Conclusion: It is imperative to choose adequate surgical tool wherever applicable; current review discusses the role of each surgical option at different clinical stages in detail.
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Affiliation(s)
- Priyanshi Awasthi
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, India
| | - Prabhakar Singh
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, India
| | - Amit Raj
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, India
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Agarwal S, Srinivasan B, Gupta R, Iyer G. Reply to Comment on: Allogenic Simple Limbal Epithelial Transplantation Versus Amniotic Membrane Grafting in the Early Management of Severe-Grade Ocular Chemical Injuries-A Retrospective Comparative Study. Am J Ophthalmol 2021; 224:343-344. [PMID: 33168148 DOI: 10.1016/j.ajo.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 11/17/2022]
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Navarro PI, Lichtinger A, Bareño J. Comment on: Allogenic Simple Limbal Epithelial Transplantation Versus Amniotic Membrane Grafting in the Early Management of Severe-Grade Ocular Chemical Injuries-A Retrospective Comparative Study. Am J Ophthalmol 2021; 224:343. [PMID: 33220893 DOI: 10.1016/j.ajo.2020.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 11/27/2022]
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