Ophthalmic applications of preserved human amniotic membrane: A review of current indications
Ophthalmic applications of preserved human amniotic membrane: A review of current indications
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DOI：
10.1023/b:catb.0000046067.25057.0a
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发表时间：
2004-01-01
影响因子：
1.5
通讯作者：
Sangwan, Virender S.
中科院分区：
文献类型：
--
作者：
Burman, Sanghamitra;Tejwani, Sushma;Sangwan, Virender S.
保存的人羊膜（AM）目前被用于广泛的眼表疾病。AM具有促进上皮细胞迁移和粘附的基底膜。独特的无血管基质基质的存在减少了炎症、新血管形成和纤维化。羊膜移植（AMT）的基本原则是促进上皮再生，重建眼表，并提供表面畸变的症状缓解。羊膜移植是一种有用的技术，用于重建表面肿瘤和睑球粘连切除后造成的表面缺损。AMT能有效地恢复持续性角膜上皮缺损和角膜溃疡患者的稳定角膜上皮。在急性眼烧伤和SJS的情况下，AMT令人满意地减少了瘢痕形成和炎症。单用AMT可能是部分角膜缘干细胞缺乏的有效替代方法。然而，同时进行AMT和角膜缘干细胞移植导致表面稳定性的显著改善，其中角膜缘移植物获自正常对侧眼、活体亲属或尸体眼。在严重或双侧病例中，供体眼睛的健康是一个主要问题。目前，保存的人AM在眼科学中最独特的应用是其用作角膜和结膜上皮的离体扩增的基质。在这种新的组织工程技术中，上皮干细胞可以安全地收获并在裸露的AM上扩增。所得到的复合培养组织已经成功地移植以恢复视力，以及受损眼表的结构和功能。
Preserved human amniotic membrane (AM) is currently being used for a wide spectrum of ocular surface disorders. The AM has a basement membrane, which promotes epithelial cell migration and adhesion. The presence of a unique avascular stromal matrix reduces inflammation, neovascularization and fibrosis. The basic tenets of amniotic membrane transplantation (AMT) are to promote re-epithelialization, to reconstruct the ocular surface and to provide symptomatic relief from surface aberrations. AMT is a useful technique for reconstruction of surface defects resulting from removal of surface tumors and symblephara. AMT has effectively restored a stable corneal epithelium in eyes with, persistent epithelial defects and corneal ulcers. In the setting of acute ocular burns and SJS, AMT has satisfactorily reduced scarring and inflammation. AMT alone may be an effective alternative for partial limbal stem cell deficiency. However remarkable improvements in surface stability have resulted from concurrent AMT and limbal stem cell transplantation, wherein the limbal grafts are obtained from the normal fellow eye, living relative or cadaveric eye. In severe or bilateral cases, well being of the donor eye is a major concern. Currently, the most unique application of preserved human AM in ophthalmology is its use as a substrate for ex-vivo expansion of corneal and conjunctival epithelium. In this novel technique of tissue engineering, epithelial stem cells can be safely harvested and expanded on denuded AM. The resultant composite cultured tissue has been successfully transplanted to restore vision, as well as the structure and function of damaged ocular surfaces.