Ophthalmology Department, Cairo University, Egypt Pathology Department, Cairo University, Egypt.
Acta Ophthalmol. 2013 Mar;91(2):e140-8. doi: 10.1111/j.1755-3768.2012.02563.x. Epub 2013 Jan 29.
To histopathologically evaluate the effect of cryopreserved human amniotic membrane (AM) transplant on preventing the development of postoperative adhesions after extraocular muscle surgery.
Ten albino rabbits were used. The superior rectus muscles were bilaterally resected. In right eyes, the muscle was wrapped with cryopreserved human AM (group AM). In left eyes, the muscle was not wrapped with AM and served as a control group (group C). The rabbits were killed, and the eyes were enucleated 6 weeks after surgery to perform histopathological examination.
On histopathological examination, the AM was present in eight eyes, surrounded by periamniotic inflammation, with no adhesions detected between rectus muscle and sclera, conjunctiva and Tenon's capsule in the segment where the AM was present, but detected elsewhere. Adhesions were detected in the other two eyes of group AM, in which the AM was absent, and in all group C eyes. When comparing eye pairs of each rabbit, AM eyes showed significantly less adhesions between the muscle and sclera (p = 0.009) and between the muscle and Tenon's capsule and conjunctiva (p = 0.008), in the region of AM application, and significantly more foreign body inflammation (p = 0.031), than C eyes. The differences between AM and C eye pairs, in terms of conjunctival inflammation and vascularity and muscle fibrosis, were insignificant (p > 0.05).
Cryopreserved AM is effective in reducing postoperative extraocular muscle adhesions. Its application is, therefore, recommended during strabismus reoperations.
通过组织病理学评估，研究冷冻保存人羊膜（AM）移植对预防眼外肌手术后粘连形成的效果。
本研究共纳入 10 只白化兔。双侧切除上直肌。右侧眼肌包裹冷冻保存的人 AM（AM 组），左侧眼肌不包裹 AM 作为对照（C 组）。术后 6 周处死动物并眼球摘出，进行组织病理学检查。
组织病理学检查发现，8 只眼的 AM 存在，周围有羊膜炎症反应，在 AM 所在的直肌段与巩膜、结膜和 Tenon 囊之间未发现粘连，但在其他部位发现粘连。AM 组的另外 2 只眼的 AM 缺失，均发现粘连，C 组所有眼均发现粘连。比较每只兔的双眼，AM 眼的直肌与巩膜（p = 0.009）和直肌与 Tenon 囊及结膜（p = 0.008）之间的粘连明显减少，在 AM 应用区域的异物炎症反应明显增加（p = 0.031），而 C 眼的上述情况均无明显差异。在结膜炎症、血管化和肌肉纤维化方面，AM 眼与 C 眼之间无显著差异（p > 0.05）。
冷冻保存的 AM 可有效减少术后眼外肌粘连，因此建议在斜视再手术中应用。
