羊膜在眼表重建中的制备和应用。

Preparation and uses of amniotic membrane for ocular surface reconstruction.

机构信息

Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

出版信息

Indian J Ophthalmol. 2023 Aug;71(8):3119. doi: 10.4103/IJO.IJO_674_23.

DOI:10.4103/IJO.IJO_674_23

PMID:37530302

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10538826/

Abstract

BACKGROUND

The use of human amniotic membrane transplantation is rapidly increasing for the management of various ocular surface disorders. Despite its numerous advantages, amniotic membrane is not widely available due to the lack of awareness among ophthalmologists regarding its preparation and preservation techniques.

PURPOSE

To provide an instructional video demonstrating the technique of harvesting, preparation, preservation of human amniotic membrane, and its uses in the management of ocular surface diseases.

SYNOPSIS

The amniotic membrane is the innermost layer of the human placenta. Properties of the amniotic membrane, like the presence of various growth factors, anti-inflammatory and anti-angiogenic factors, and its low immunogenicity, contribute to its ability to promote epithelial growth and differentiation with the reduction in fibrosis during healing. To harvest amniotic membrane, informed consent is obtained from a patient undergoing an elective caesarian section, and the donor is screened to exclude the risk of infections. Under sterile precautions, the amniotic membrane is separated from the chorion and washed free of blood clots. With the epithelial surface up, the amniotic membrane is spread uniformly without folds or tears on individually sterilized 0.22 μm nitrocellulose filter papers of the required sizes. The prepared filter paper with the adherent amniotic membrane is placed in freshly prepared Dulbecco's Modified Eagle's Medium and stored at -80°C. The amniotic membrane can be used for surgical procedures like symblepharon release, pterygium or dermoid excision, perforated ulcers, nonhealing epithelial defects, etc.

HIGHLIGHTS

Instructional videos demonstrating the preparation and preservation of amniotic membrane are very sparse. This video clearly explains how any ophthalmologist can learn to prepare and preserve the human amniotic membrane and gives a glimpse of its properties, advantages, and scope of use.

VIDEO LINK

https://youtu.be/8HfSjXUKoiY.

摘要

背景

人羊膜移植在治疗各种眼表疾病中的应用迅速增加。尽管人羊膜具有许多优点，但由于眼科医生对其制备和保存技术缺乏认识，因此人羊膜的供应并不广泛。

目的

提供一个教学视频，演示人羊膜的采集、准备、保存技术及其在眼表疾病管理中的应用。

概要

人羊膜是人胎盘的最内层。羊膜的特性，如存在各种生长因子、抗炎和抗血管生成因子，以及其低免疫原性，有助于其促进上皮细胞生长和分化，减少愈合过程中的纤维化。为了采集人羊膜，从接受选择性剖宫产的患者处获得知情同意，并对供体进行筛查以排除感染风险。在无菌预防措施下，将羊膜与绒毛膜分离，并清洗干净，去除血块。将羊膜的上皮面朝上，均匀地铺在单独消毒的 0.22μm 硝酸纤维素滤纸上，大小要求合适，避免出现褶皱或撕裂。准备好的滤纸上附有羊膜，然后将其放在新鲜制备的杜尔贝科改良鹰培养基中，储存在-80°C。羊膜可用于手术程序，如睑球粘连松解术、翼状胬肉或皮样囊肿切除术、穿孔性溃疡、愈合不良的上皮缺损等。