rss
Br J Ophthalmol doi:10.1136/bjo.2007.123026

Amniotic membrane transplantation for the management of corneal epithelial defects: An in vivo confocal microscopic study.

  1. Mario Nubile (m.nubile{at}unich.it),
  2. Harminder S Dua (hdua{at}onetel.com),
  3. Manuela Lanzini (manulanzini{at}virgilio.it),
  4. Paolo Carpineto (p.carpineto{at}unich.it),
  5. Marco Ciancaglini (m.ciancaglini{at}unich.it),
  6. Lisa Toto (totolisa{at}hotmail.com),
  7. Leonardo Mastropasqua (mastropa{at}unich.it)
  1. Ophthalmology Clinic, University "G. d'Annunzio" of Chieti-Pescara, Italy, Italy
  2. Division of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, United Kingdom, United Kingdom
  3. Ophthalmology Clinic, University "G. d'Annunzio" of Chieti-Pescara, Italy, Italy
  4. Ophthalmology Clinic, University "G. d'Annunzio" of Chieti-Pescara, Italy, Italy
  5. Ophthalmology Clinic, University "G. d'Annunzio" of Chieti-Pescara, Italy, Italy
  6. Ophthalmology Clinic, University "G. d'Annunzio" of Chieti-Pescara, Italy, Italy
  7. Ophthalmology Clinic, University "G. d'Annunzio" of Chieti-Pescara, Italy, Italy
    • Published Online First 21 June 2007

    Abstract

    Purpose: To evaluate amniotic membrane (AM) tissue morphology and corneal epithelial healing in human eyes after amniotic membrane transplantation (AMT), using laser scanning in vivo confocal microscopy (IVCM).

    Patients and methods: Twenty eyes of twenty patients, treated with single layer epithelial side up AMT for chemical burns in the acute stage (n=8) and persistent corneal epithelial defect (n=12) were studied by serial IVCM post AMT until complete re-epithelization. Changes in morphology of transplanted amniotic tissue and healing corneal epithelium were noted. AM and corneal epithelial cell density was calculated using image analysis software.

    Results: IVCM enabled visualisation of transplanted AM and of regenerating epithelial cells under the AM. The mean AM epithelial cell density, one day after transplant, was 4613 ± 380 cell/mm2. Average AM epithelial thickness was 35 ± 4 μm, while AM stromal thickness was 116 ± 31 μm. The amniotic stroma appeared to be composed of a superficial dense fibrous layer and a deeper loose reticular network of fibers. Amniotic epithelium was lost within 15 days of transplant and complete re-epithelisation of the corneal surface was achieved between one and four weeks.

    Conclusions: Laser scanning IVCM is a useful method for evaluating AM tissue morphology, degradation and corneal epithelial healing after AMT for different clinical indications. When the amniotic membrane acts as a patch, i.e. epithelial cells migrate under rather than over the membrane, the membrane disintegrates and is lost.

    Relevant Article

    • At a glance:At a glance
      • Harminder S Dua,
      • Arun D Singh, Editors-in-Chief
      Br J Ophthalmol 2008;92:1

    This Article

    1. Abstract
    2. PDF
    3. All versions of this article:
      1. bjo.2007.123026v1
      2. 92/1/54most recent

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.