Sekiyama Eiichi, Nakamura Takahiro, Kurihara Eiji, Cooper Leanne J, Fullwood Nigel J, Takaoka Maho, Hamuro Junji, Kinoshita Shigeru
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Graduate School of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-0841, Japan.
Invest Ophthalmol Vis Sci. 2007 Apr;48(4):1528-34. doi: 10.1167/iovs.06-1104.
To evaluate the efficacy and safety of a novel sutureless transplantation of bioadhesive-coated, sterilized, freeze-dried amniotic membrane (FD-AM) for ocular surface reconstruction.
A bioadhesive-coated, freeze-dried amniotic membrane was made by freeze drying the denuded AM in a vacuum, applying the minimum amount of fibrin glue (mixture of fibrinogen and thrombin) necessary to retain adhesion on the chorionic side, and sterilizing it by gamma-radiation. The resultant AM was characterized for its biological and morphologic properties by immunohistochemical and electron microscopic examination. In addition, fibrin glue-coated, freeze-dried (FCFD) AM was transplanted onto a rabbit scleral surface without sutures, to examine its biocompatibility.
Immunohistochemistry of the FCFD-AM revealed that fibrinogen existed on its chorionic side, and the process of applying fibrin glue did not affect its biological and morphologic properties. Moreover, electron microscopic examination of the chorionic side of the FCFD-AM revealed tiny microfibrils (which are probably fibrinogen protofibrils), and showed that the epithelial surface of FCFD-AM consisted of intact basal lamina similar to that of FD-AM. FCFD-AM transplantation was very easily performed, and the graft adhered to the bare sclera immediately. Though the fibrinogen naturally biodegraded within 2 weeks, the FCFD-AM remained for at least 12 weeks after transplantation. Epithelialization on the FCFD-AM was achieved within 2 weeks, as was the case with FD-AM transplantation. The conjunctival epithelium on the FCFD-AM was well stratified and not keratinized, suggesting that FCFD-AM supports normal cell differentiation.
The FCFD-AM retained most of the biological characteristics of FD-AM. Consequently, this sutureless method of transplantation of FCFD-AM is safe, simple, and useful for ocular surface reconstruction.
评估一种新型的生物黏附涂层、灭菌、冻干羊膜（FD - AM）无缝合移植用于眼表重建的有效性和安全性。
通过在真空中冻干去除上皮的羊膜，在绒毛膜侧涂抹维持黏附所需的最少量纤维蛋白胶（纤维蛋白原和凝血酶的混合物），并通过伽马射线灭菌，制成生物黏附涂层、冻干羊膜。通过免疫组织化学和电子显微镜检查对所得羊膜的生物学和形态学特性进行表征。此外，将纤维蛋白胶涂层、冻干（FCFD）羊膜无缝合移植到兔巩膜表面，以检查其生物相容性。
FCFD - AM的免疫组织化学显示纤维蛋白原存在于其绒毛膜侧，涂抹纤维蛋白胶的过程未影响其生物学和形态学特性。此外，对FCFD - AM绒毛膜侧的电子显微镜检查发现微小的微纤维（可能是纤维蛋白原原纤维），并表明FCFD - AM的上皮表面由与FD - AM相似的完整基膜组成。FCFD - AM移植操作非常容易，移植物立即黏附于裸露的巩膜。尽管纤维蛋白原在2周内自然降解，但FCFD - AM在移植后至少保留12周。与FD - AM移植情况一样，FCFD - AM在2周内实现上皮化。FCFD - AM上的结膜上皮分层良好且未角化，表明FCFD - AM支持正常细胞分化。
FCFD - AM保留了FD - AM的大部分生物学特性。因此，这种FCFD - AM的无缝合移植方法对于眼表重建是安全、简单且有用的。
