Caporossi Tomaso, Molle Andrea, Carlà Matteo Mario, Picardi Stefano Maria, Gambini Gloria, Scampoli Alessandra, Governatori Lorenzo, Bernardinelli Patrizio, Rizzo Stanislao
Head, Neck and Sensory Organs Department, Catholic University of the Sacred Heart, 00168 Rome, Italy.
Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina Gemelli Isola Hospital, 00186 Rome, Italy.
J Clin Med. 2023 Feb 1;12(3):1137. doi: 10.3390/jcm12031137.
Human amniotic membranes (hAMs) are extraembryonic tissues currently employed in the treatment of many ocular and systemic diseases. Several reports indicate that hAMs can suppress the signaling pathway of tissue growth factor beta (TGF-β), a cytokine that plays a major role in the pathogenesis of proliferative vitreoretinopathy (PVR) through the induction of epithelial-mesenchymal transition (EMT) in exposed retinal pigmented epithelium (RPE) cells. The present study was conducted to evaluate the efficacy of a modified vitrectomy procedure (hAMP-V) involving the extensive coverage of exposed RPE with hAM patches to prevent postoperative PVR in a series of 15 cases of retinal detachment complicated by severe preoperatory PVR. The primary outcome was to assess the rate of successful retinal reattachment of a single hAMP-V procedure at 6 months from silicone oil removal. Secondary outcomes included the collection of intraoperative data concerning the quantity, size, and scope of hAM patches, and the assessment of postoperative improvements in mean LogMar BCVA at 3 and 6 months. Successful retinal reattachment was obtained in 14 out of 15 eyes (93.3%). Surgical failure due to major recurrence of PVR occurred in 1 out of 15 eyes (6.7%). Postoperative improvements in mean LogMar BCVA were statistically significant ( < 0.05, paired -test). No intraoperative and postoperative adverse effects were reported. The study helped to refine the surgical technique while also offering cues for future improvements.
人羊膜（hAMs）是目前用于治疗多种眼部和全身性疾病的胚外组织。多项报告表明，hAMs可抑制组织生长因子β（TGF-β）的信号通路，TGF-β是一种细胞因子，通过诱导暴露的视网膜色素上皮（RPE）细胞发生上皮-间质转化（EMT），在增殖性玻璃体视网膜病变（PVR）的发病机制中起主要作用。本研究旨在评估一种改良玻璃体切除术（hAMP-V）的疗效，该手术采用hAM贴片广泛覆盖暴露的RPE，以预防15例术前合并严重PVR的视网膜脱离患者术后发生PVR。主要结局是评估硅油取出后6个月时单次hAMP-V手术视网膜成功复位率。次要结局包括收集术中有关hAM贴片数量、大小和范围的数据，以及评估术后3个月和6个月时平均LogMar最佳矫正视力（BCVA）的改善情况。15只眼中有14只（93.3%）视网膜成功复位。因PVR严重复发导致手术失败的有15只眼中的1只（6.7%）。术后平均LogMar BCVA的改善具有统计学意义（<0.05，配对检验）。未报告术中及术后不良反应。该研究有助于完善手术技术，同时也为未来的改进提供了线索。
