Sippel K C, Ma J J, Foster C S
Cornea Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.
Curr Opin Ophthalmol. 2001 Aug;12(4):269-81. doi: 10.1097/00055735-200108000-00006.
Human amniotic membrane (AM) is composed of three layers: a single epithelial layer, a thick basement membrane, and an avascular stroma. Amniotic membrane has anti-adhesive properties and is felt to promote epithelialization and decrease inflammation, neovascularization, and fibrosis. Amniotic membrane transplantation (AMT) is currently being used for a continuously widening spectrum of ophthalmic indications. Amniotic membrane transplantation has been shown to be effective in the reconstruction of the corneal surface in the setting of persistent epithelial defects, sterile corneal ulcerations, and partial limbal stem cell (LSC) deficiency states, including those secondary to chemical or thermal burns. Amniotic membrane transplantation also has been used in conjunction with limbal stem cell transplantation (LSCT) both in a concurrent fashion as well as in preparation for LSCT. Amniotic membrane transplantation also has been used in place of conjunctival autografting after pterygium excision and to reconstruct the conjunctival surface after removal of conjunctival lesions. Most recently, ex vivo cultivation and expansion of limbal epithelial cells has been performed utilizing AM as a matrix. However, the superiority of AMT over other treatment modalities in many of these settings needs to be substantiated by controlled clinical trials.
人羊膜（AM）由三层组成：单层上皮层、厚基底膜和无血管基质。羊膜具有抗粘连特性，被认为可促进上皮形成并减少炎症、新生血管形成和纤维化。羊膜移植（AMT）目前正用于越来越广泛的眼科适应证。已证明羊膜移植在持续性上皮缺损、无菌性角膜溃疡和部分角膜缘干细胞（LSC）缺乏状态（包括化学或热烧伤继发的状态）下重建角膜表面有效。羊膜移植也已与角膜缘干细胞移植（LSCT）同时或作为LSCT的术前准备联合使用。羊膜移植还已用于翼状胬肉切除术后替代结膜自体移植以及在切除结膜病变后重建结膜表面。最近，已利用羊膜作为基质进行角膜缘上皮细胞的体外培养和扩增。然而，在许多这些情况下，AMT相对于其他治疗方式的优越性需要通过对照临床试验来证实。
