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USE OF AMNIOTIC MEMBRANE IN OPHTHALMOLOGY

(modified Abstract from "Amniotic membrane in ophthalmology: properties, preparation, storage and indications for grafting—a review"; Jirsova, K. & Jones, G.L.A. - Cell and Tissue Banking, June 2017, Volume 18, Issue 2, pp 193–204)

The use of amniotic membrane (the innermost layer of the placenta that surrounds a baby during pregnancy) in ophthalmic surgery, together with other surgical procedures in the fields of dermatology, plastic surgery, genitourinary medicine and otolaryngology, is widespread and on the increase. Furthermore, amniotic membrane and its epithelial and mesenchymal cells have broad use in regenerative medicine.

Amniotic membrane contains a rich source of biologically active factors and as such, promotes healing and acts as an effective material for wound dressing. Amniotic membrane supports epithelialization and exhibits anti-fibrotic, anti-inflammatory, anti-angiogenic and anti-microbial features. Placentas utilised in the preparation of amniotic membrane are retrieved from donors undergoing elective caesarean section. Maternal blood must undergo serological screening at the time of donation and, in the absence of advanced diagnostic testing techniques, 6 months postpartum in order to cover the time window for the potential transmission of communicable diseases.

Amniotic membrane is prepared by blunt dissection under strict aseptic conditions, then is typically transferred onto a nitrocellulose paper carrier, usually with the epithelial side up, and cut into multiple pieces of different dimensions. Amniotic membrane can be stored under various conditions, most often cryopreserved in glycerol or dimethyl sulfoxide or their mixture with culture medium or buffers. Other preservation methods include lyophilisation and air-drying.

In ophthalmology, amniotic membrane is increasingly used for ocular surface reconstruction, including the treatment of persistent epithelial defects and non-healing corneal ulcers, corneal perforations and descemetoceles, bullous keratopathy, as well as corneal disorders with associated limbal stem cell deficiency, pterygium, conjunctival reconstruction, corneoscleral melts and perforations, and glaucoma surgeries.

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