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Anitha V, Ghorpade A, Haridas RT, Ravindran M, Uduman MS. Clinical outcomes, time span for healing of various ocular surface disorders with amniotic membrane: A prospective, an Indian study. Indian J Ophthalmol 2023; 71:3186-3191. [PMID: 37602606 PMCID: PMC10565922 DOI: 10.4103/ijo.ijo_2904_22] [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: 11/01/2022] [Revised: 04/17/2023] [Accepted: 06/08/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To study the clinical outcomes, time span of healing of various ocular surface disorders with amniotic membrane graft. Methods A total of 41 patients, presenting to cornea clinic were included in the study and divided into five groups depending on the type of diagnosis: Group 1, with either >2 weeks of Persistent epithelial defect following cataract/retinal/glaucoma surgeries or Shield ulcers, Group 2 with >4 weeks of Non healing corneal ulcers, Group 3 with chemical injuries, Group 4 with Epithelial defects following keratoplasty, and Group 5 is the miscellaneous group. Results The mean age of the study subjects was 50.0 years. Overall mean duration between clinical presentation and AMT was 23.59 (30.7) days, a median 16 days (IQR; 2-26 days). Failure rate was high in Group 5 (n = 3: 30.0%) and Group 2 (n = 3: 27.3%). Time taken for epithelial closure was slower in groups 1 and 5 patients. The average time taken for reabsorption of AMG was 14.98 days. The complications included repeat AMG was in four eyes (9.75%), and graft displacement was noted in four eyes (9.75%) required resuturing, three eyes required TPK (7.31%), and one eye underwent evisceration (2.43%) following severe corneal melt secondary to neurotropic ulcer. The mean log MAR visual acuity improved from 1.52 to 1.26 at the 3 months. Conclusion Understanding on timespan for healing of ocular surface disorders with AMG is needed to assess the prognosis of the disease, preoperative counselling for repeat procedures, and the compliance with regard to follow up.
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Affiliation(s)
- Venugopal Anitha
- Cornea and Refractive Services, Paediatric and Strabismus Surgery, Tirunelveli, Tamil Nadu, India
| | - Aditya Ghorpade
- Cornea and Refractive Services, Paediatric and Strabismus Surgery, Tirunelveli, Tamil Nadu, India
| | - R T Haridas
- Fellow in Retina, Retina Services, Paediatric and Strabismus Surgery, Tirunelveli, Tamil Nadu, India
| | - Meenakshi Ravindran
- Chief Medical Officer, Paediatric and Strabismus Surgery, Tirunelveli, Tamil Nadu, India
| | - Mohammed S Uduman
- BioStatistician, Aravind Eye Hospital, Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
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Pan J, Zhang W, Zhu J, Tan J, Huang Y, Mo K, Tong Y, Xie Z, Ke Y, Zheng H, Ouyang H, Shi X, Gao L. Arrested Phase Separation Enables High-Performance Keratoprostheses. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2207750. [PMID: 36680510 DOI: 10.1002/adma.202207750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/24/2022] [Indexed: 06/17/2023]
Abstract
Corneal transplantation is impeded by donor shortages, immune rejection, and ethical reservations. Pre-made cornea prostheses (keratoprostheses) offer a proven option to alleviate these issues. Ideal keratoprostheses must possess optical clarity and mechanical robustness, but also high permeability, processability, and recyclability. Here, it is shown that rationally controlling the extent of arrested phase separation can lead to optimized multiscale structure that reconciles permeability and transparency, a previously conflicting goal by common pore-forming strategies. The process is simply accomplished by hydrothermally treating a dense and transparent hydrophobic association hydrogel. The examination of multiscale structure evolution during hydrothermal treatment reveals that the phase separation with upper miscibility gap evolves to confer time-dependent pore growth due to slow dynamics of polymer-rich phase which is close to vitrification. Such a process can render a combination of multiple desired properties that equal or surpass those of the state-of-the-art keratoprostheses. In vivo tests confirm that the keratoprosthesis can effectively repair corneal perforation and restore a transparent cornea with treatment outcomes akin to that of allo-keratoplasty. The keratoprosthesis is easy to access and convenient to carry, and thus would be an effective temporary substitute for a corneal allograft in emergency conditions.
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Affiliation(s)
- Jiageng Pan
- School of Chemical Engineering and Light Industry, Gangdong University of Technology, Guangzhou, 510006, P. R. China
| | - Wang Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, P. R. China
| | - Jin Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, P. R. China
| | - Jieying Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, P. R. China
| | - Ying Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, P. R. China
| | - Kunlun Mo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, P. R. China
| | - Yan Tong
- School of Materials, Sun Yat-sen University, Guangzhou, 510060, P. R. China
| | - Zhenhua Xie
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, P. R. China
- Spallation Neutron Source Science Center, Dongguan, 523803, P. R. China
| | - Yubin Ke
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, P. R. China
- Spallation Neutron Source Science Center, Dongguan, 523803, P. R. China
| | - Huade Zheng
- School of Materials Science and Engineering, South China University of Technology, Guanghzhou, 510640, P. R. China
| | - Hong Ouyang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, P. R. China
| | - Xuetao Shi
- School of Materials Science and Engineering, South China University of Technology, Guanghzhou, 510640, P. R. China
| | - Liang Gao
- School of Chemical Engineering and Light Industry, Gangdong University of Technology, Guangzhou, 510006, P. R. China
- Jieyang Branch of Chemistry and Chemical Engineering Guangdong Laboratory (Rongjiang Laboratory), Jieyang, 515200, P. R. China
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Horii T, Jonin K, Kageyama S, Yoshida T, Kobayashi K, Minato H, Ueda J, Tsujimoto H, Hagiwara A, Ichikawa H, Kawauchi A. Regeneration of Functional Bladder Using Cell-seeded Amnion and P(LA/CL) Scaffolds. Tissue Eng Part A 2022; 28:968-976. [PMID: 36082995 DOI: 10.1089/ten.tea.2022.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Long-term bladder regeneration hasn't been successful instead of augmentation with gastrointestinal segments, as is commonly performed for bladder reconstruction. To evaluate whether or not cell-seeded bioabsorbable materials regenerate half-resected bladder in a rabbit model. EXPERIMENT Female Japanese white rabbits were divided two groups: cell-seeded material (CSM) group and Control (n=6 each). Control rabbits underwent resection of half the bladder. CSM rabbits were sutured with cell-seeded amniotic membrane and P(LA/CL) material after bladder resection. After 6, 12, and 18 months, rabbits underwent X-ray and cystometry, and bladder tissues after 18 months were subjected to functional and histological analyses. RESULTS X-ray confirmed the peristaltic movements of the reconstructed bladders in the CSM group. On cystometry, the mean maximum bladder volume, maximum bladder pressure, and 25 mL bladder volume compliance in the CSM group were significantly greater than in the control group at 6, 12, and 18 months. In addition, organ bath studies showed good contraction under electrical stimulation with increasing stimulation frequency in the CSM group, while, the control group showed weak contraction on both tests in the central marginal zone. Furthermore, the rates of neo-vascularization, urothelial and smooth muscle formation and neurofilamentation in the CSM group were significantly greater than in the control group. CONCLUSIONS Oral mucosal cell-seeded amniotic membrane and stomach smooth muscle cell- seeded P(LA/CL) scaffold with omentum after abdominal implantation regenerated functional bladder with satisfactory epithelium and smooth muscle without scarring more than one year.
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Affiliation(s)
- Tsunehito Horii
- Shiga University of Medical Science, Urology, Otsu, Japan.,Doshisha University, Life and Medical Science, Kyotanabe, Kyoto, Japan;
| | | | | | | | | | | | - Joe Ueda
- Ueda Clinic, Gastroenterology, Takanosu, Japan;
| | - Hiroyuki Tsujimoto
- Shiga University of Medical Science, Urology, Otsu, Japan.,Doshisha University, Life and Medical Science, Kyotanabe, Kyoto, Japan;
| | - Akeo Hagiwara
- Shiga University of Medical Science, Urology, Otsu, Japan.,Doshisha University, Life and Medical Science, Kyotanabe, Kyoto, Japan;
| | - Hiroshi Ichikawa
- Doshisha University, Life and Medical Science, Kyotanabe, Kyoto, Japan;
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Yang Y, Fung SSM, Chew H, Mireskandari K, Ali A. Amniotic membrane transplantation for Stevens-Johnson syndrome/toxic epidermal necrolysis: the Toronto experience. Br J Ophthalmol 2020; 105:1238-1243. [PMID: 32830126 DOI: 10.1136/bjophthalmol-2020-316056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/13/2020] [Accepted: 08/03/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Yelin Yang
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Simon Sheung Man Fung
- Department of Ophthalmology, University of California Los Angeles, Los Angeles, California, USA
| | - Hall Chew
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kamiar Mireskandari
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Asim Ali
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada .,Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
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Abstract
The main treatment for pterygium is surgical removal. However, pterygium surgery is concerned with high rates of postoperative recurrence. Predicting factors of recurrence are not fully understood, yet, but they probably depend on a multitude of patient-related, clinical, and/or surgical factors. Several adjuvant treatments have been proposed to reduce postoperative pterygium recurrence, including different antimetabolites, antiangiogenetic factors, and radiation therapy. The purpose of this review is to collect the current evidence regarding application and limits of different therapeutic approaches for preventing postoperative recurrence of pterygium, giving insights and perspectives for better management of this disease. In the light of the current evidence, pterygium surgery cannot disregard wound coverage with conjunctival autografting or rotational flap combined with adjuvant treatments. The rotational flap technique is associated with shorter surgical time rates and prevents graft displacement and necrosis, given its vascular pedicle. Amniotic membrane may still be reserved in case of great conjunctival defects or insufficient conjunctiva. Repeated subconjunctival antivascular endothelial growth factor injections can be considered as an effective and safe adjuvant treatment. Moreover, management of postoperative pain is crucial. Innovative treatment strategies will probably target different molecular pathways, considering recent findings regarding pterygium pathogenesis, to improve better understanding and develop universally shared guidelines. Great importance shall be dedicated to the identification of novel molecular biomarkers and favoring factors of recurrence, in order to achieve a customized surgical treatment for each patient and obtain maximal reduction of postoperative recurrence.
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Affiliation(s)
- Raffaele Nuzzi
- S.C.U. Ophthalmology Unit, "City of Health and Science" University Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy,
| | - Federico Tridico
- S.C.U. Ophthalmology Unit, "City of Health and Science" University Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy,
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Comparison of Collagen Cross-Linking and Amniotic Membrane Transplantation in an Experimental Alkali Burn Rabbit Model. Cornea 2018; 36:1106-1115. [PMID: 28704317 DOI: 10.1097/ico.0000000000001276] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the effects of collagen cross-linking (CXL) and amniotic membrane transplantation (AMT) on acute corneal alkali burns. METHODS After establishment of an alkali burn model, 32 rabbits were divided into 4 groups: control group, AMT group, CXL group, and AMT + CXL (combined) group. Clinical parameters, including epithelial wound, opacity, ulceration, and neovascularization, were evaluated on postinjury days 1, 7, 14, and 18. Histological parameters were examined in hematoxylin/eosin (H&E) and Masson trichrome-stained corneal sections. Immunohistochemical analyses, including a terminal deoxynucleotidyl transferase-mediated biotin-deoxyuridine triphosphate nick-end labeling assay and cluster of differentiation 68 (CD68) labeling, were performed to determine the apoptotic index and macrophage activation. RESULTS On postinjury day 18, the epithelial wound of AMT {4.08% [interquartile range (IQR), 0.68%-5.22%]}, CXL [1.84% (IQR, 0.01%-3.89%)], and combined [3.44% (IQR, 0.01%-4.36%)] groups were significantly lower than the control [15.23% (IQR, 9.86%-23.06%)] group (P = 0.003). No significant difference was detected between the groups in terms of opacity (P = 0.303). Neovascularization was the least severe in the CXL group [16.18% (IQR, 8.39%-21.28%)] and the most severe in the AMT [34.47% (IQR, 17.71%-62.77%)] and combined [35.12% (IQR, 31.96%-59.98%)] groups on day 18 (P = 0.033). Significant increases in the apoptotic index and CD68 labeling were detected in the CXL and combined groups compared with those in the control group (P = 0.047 and P = 0.001, respectively). CONCLUSIONS CXL treatment is an effective adjuvant treatment for promoting reepithelialization, reducing inflammation and neovascularization, and preventing ulceration in acute alkali burns. Providing AMT after suppressing inflammation may be a more effective treatment.
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Cardenas-Cantu E, Valenzuela J, Zavala J, Valdez-Garcýa JE. Basis of Pterygium Development. ACTA ACUST UNITED AC 2016. [DOI: 10.5005/highlights-44-6-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
Pterygium pathogenesis is mainly related to UV light exposure. However, the exact mechanisms by which it is formed have not been elucidated. Clinical advances in surgical treatment use conjunctival autografts and amniotic membranes in combination with adjuvant therapies, including mitomycin C, β-radiation, and 5-fluoroacil, to reduce recurrence. Several studies aim to unveil the molecular mechanisms underlying pterygium growth and proliferation. They demonstrate the role of different factors, such as viruses, oxidative stress, DNA methylation, apoptotic and oncogenic proteins, loss of heterozygosity, microsatellite instability, inflammatory mediators, extracellular matrix modulators, lymphangiogenesis, cell epithelial-mesenchymal transition, and alterations in cholesterol metabolism in pterygium development. Understanding the molecular basis of pterygium provides new potential therapeutic targets for its prevention and elimination. This review focuses on providing a broad overview of what is currently known regarding molecular mechanisms of pterygium pathogenesis.
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Affiliation(s)
- Eduardo Cárdenas-Cantú
- a Ophthalmology Research Chair, School of Medicine and Health Sciences, Tecnologico de Monterrey , Monterrey , Mexico and
| | - Judith Zavala
- a Ophthalmology Research Chair, School of Medicine and Health Sciences, Tecnologico de Monterrey , Monterrey , Mexico and
| | - Jorge Valenzuela
- a Ophthalmology Research Chair, School of Medicine and Health Sciences, Tecnologico de Monterrey , Monterrey , Mexico and
| | - Jorge E Valdez-García
- a Ophthalmology Research Chair, School of Medicine and Health Sciences, Tecnologico de Monterrey , Monterrey , Mexico and.,b Ophthalmology Institute, Tec Salud, Tecnologico de Monterrey , Monterrey , Mexico
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Ghahramani L, Jahromi AB, Dehghani MR, Ashraf MJ, Rahimikazerooni S, Rezaianzadeh A, Safarpour AR, Hosseini SV. Evaluation of repair in duodenal perforation with human amniotic membrane: An animal model (dog). Adv Biomed Res 2014; 3:113. [PMID: 24804187 PMCID: PMC4009825 DOI: 10.4103/2277-9175.131029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 10/26/2013] [Indexed: 01/31/2023] Open
Abstract
Background: There is a growing tendency toward application of human amniotic membrane (HAM) as a biologic substitute in various tissue injuries where a significant tissue loss is a matter of concern. In gastrointestinal injuries especially duodenal ones, some potential limitations in current surgical techniques contribute to not fully acceptable healing outcomes. Thus, this study was carried out to assess repair with HAM patch for duodenal defect in comparison with simple duodenoraphy in an animal model (dog). Materials and Methods: A total of 15 male German shepherd dogs weighing 23-27 kg were randomly divided into two groups. Group A with 10 dogs, which were a candidate for duodenal repair by amniotic membrane patch and Group B consisted of 5 dogs perform simple duodenorraphy. A precise control was made to match all conditions except surgical technique. Macroscopic and microscopic features of the healed duodenal lumen in both groups were recorded. Results: Gross evaluation revealed no difference in luminal diameter in both groups. Statistical analysis of duodenal diameter between both groups after operation also showed no significant difference (Pv = 0.789). Histological assessment indicated less inflammation with better wound healing in Group A. Conclusion: It seems that repairing duodenal wall defect with HAM would result in better histological outcomes compared with what is seen in simple duodenoraphy in animal models. However, there is no significant difference regarding surgical findings.
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Affiliation(s)
- Leila Ghahramani
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | | | | | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Reza Safarpour
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Willett NJ, Thote T, Lin ASP, Moran S, Raji Y, Sridaran S, Stevens HY, Guldberg RE. Intra-articular injection of micronized dehydrated human amnion/chorion membrane attenuates osteoarthritis development. Arthritis Res Ther 2014; 16:R47. [PMID: 24499554 PMCID: PMC3978824 DOI: 10.1186/ar4476] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 01/27/2014] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Micronized dehydrated human amnion/chorion membrane (μ-dHACM) is derived from donated human placentae and has anti-inflammatory, low immunogenic and anti-fibrotic properties. The objective of this study was to quantitatively assess the efficacy of μ-dHACM as a disease modifying intervention in a rat model of osteoarthritis (OA). It was hypothesized that intra-articular injection of μ-dHACM would attenuate OA progression. METHODS Lewis rats underwent medial meniscal transection (MMT) surgery to induce OA. Twenty four hours post-surgery, μ-dHACM or saline was injected intra-articularly into the rat joint. Naïve rats also received μ-dHACM injections. Microstructural changes in the tibial articular cartilage were assessed using equilibrium partitioning of an ionic contrast agent (EPIC-μCT) at 21 days post-surgery. The joint was also evaluated histologically and synovial fluid was analyzed for inflammatory markers at 3 and 21 days post-surgery. RESULTS There was no measured baseline effect of μ-dHACM on cartilage in naïve animals. Histological staining of treated joints showed presence of μ-dHACM in the synovium along with local hypercellularity at 3 and 21 days post-surgery. In MMT animals, development of cartilage lesions at 21 days was prevented and number of partial erosions was significantly reduced by treatment with μ-dHACM. EPIC-μCT analysis quantitatively showed that μ-dHACM reduced proteoglycan loss in MMT animals. CONCLUSIONS μ-dHACM is rapidly sequestered in the synovial membrane following intra-articular injection and attenuates cartilage degradation in a rat OA model. These data suggest that intra-articular delivery of μ-dHACM may have a therapeutic effect on OA development.
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Chien KH, Chen SJ, Liu JH, Woung LC, Chen JT, Liang CM, Chiou SH, Tsai CY, Cheng CK, Hu CC, Peng CH. Correlation of MicroRNA-145 Levels and Clinical Severity of Pterygia. Ocul Surf 2013; 11:133-8. [DOI: 10.1016/j.jtos.2012.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 11/13/2012] [Accepted: 12/14/2012] [Indexed: 12/31/2022]
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Schulze U, Hampel U, Sel S, Goecke TW, Thäle V, Garreis F, Paulsen F. Fresh and cryopreserved amniotic membrane secrete the trefoil factor family peptide 3 that is well known to promote wound healing. Histochem Cell Biol 2012; 138:243-50. [DOI: 10.1007/s00418-012-0943-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2012] [Indexed: 01/28/2023]
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