Journal
INTERNATIONAL OPHTHALMOLOGY
Volume 43, Issue 5, Pages 1771-1783Publisher
SPRINGER
DOI: 10.1007/s10792-022-02570-5
Keywords
Amniotic membrane; Trabeculectomy; Glaucoma treatment; Vitreoretinal procedures; Macular hole; Retinal detachment
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The main reasons for transplanting amniotic membrane (AM) in ophthalmology are to promote cellular growth, provide tectonic support, protect the wound, and facilitate wound healing. It has been widely used in corneal disorders and has shown potential in conjunctival disorders, glaucoma, and vitreoretinal procedures. Studies have shown that AM transplant with trabeculectomy can effectively improve intraocular pressure and enhance the success rate of trabeculectomies when used with mitomycin C. AM has also been used as a tectonic support in shunt procedures and has shown successful results in vitreoretinal procedures. However, further studies are needed to refine surgical techniques and better understand its therapeutic effects.
The main reasons why Amniotic Membrane (AM) is transplanted in Ophthalmology are: to provide a substrate for cellular growth and to provide tectonic support or as a biological bandage and barrier that protects the wound to facilitate an environment for wound healing. The application of AM is well-documented in corneal disorders of various aetiologies [1], however, research within the field has highlighted how it can be used in conjunctival disorders and most recently, in glaucoma and vitreoretinal procedures. This review explores the preservation modalities of AM and summarises the current literature regarding AM transplantation in Glaucoma and Vitreoretinal conditions. AM transplantation in conjunction with trabeculectomy was reported to be used in two different surgical techniques. They differ in relation to the position of the implant: below the scleral flap or over the entire exposed sclera. The results of these studies suggest that AM transplant is a safe procedure that helps in the improvement of the intraocular pressure when associated with trabeculectomies. Moreover, it enhances trabeculectomies success rates when used along with mitomycin C [2]. The use of AM is also described for managing leaking blebs. It is mentioned to be a suitable alternative to conjunctival advancement. Regarding AM transplantation in glaucoma shunt or valve surgeries, the current literature is relatively limited. However, AM has been described as a good tectonic support for shunt procedures [3]. Successful results are described in the literature for surgical treatments using AM plug for vitreoretinal procedures. In particular macular hole closure and rhegmatogenous retinal detachment. In conclusion, AM transplant is a very promising and versatile adjutant therapy. However, further studies are also required for a better understanding and refinement of surgical techniques.
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