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Transplantation of Preserved Human Amniotic Membrane for Surface Reconstruction in Severely Damaged Rabbit Corneas
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1995
Year
Tissue EngineeringEngineeringTissue TransplantationBiomedical EngineeringOrgan PreservationRegenerative MedicineCorneal Surface ReconstructionSurface ReconstructionTransplantation SurgeryXenotransplantationOphthalmologyCorneal DystrophyOcular TissueDevelopmental BiologyExperimental OphthalmologyAdditional TransplantationWound HealingMedicineN-heptanol Removal
Removal of the corneal epithelium and limbal lamellar keratectomy in rabbits induces limbal stem cell deficiency, characterized by conjunctival epithelial ingrowth, vascularization, and chronic inflammation. The study compared total keratectomy alone (10 eyes) to keratectomy plus transplantation of glycerin‑preserved human amniotic membrane (13 eyes) one month after injury. After three months, the amniotic‑membrane group showed clearer corneas with minimal or no vascularization in five eyes, whereas controls developed central vascularization and granuloma; success correlated with a cornea‑like epithelial phenotype and preserved membrane, suggesting that preventing fibrovascular ingrowth may make the procedure clinically useful.
After n-heptanol removal of the total corneal epithelium and a limbal lamellar keratectomy, 23 rabbit eyes developed features of limbal stem cell deficiency including conjunctival epithelial ingrowth, vascularization and chronic inflammation. One month later, 10 control eyes received a total keratectomy, and 13 experimental eyes received additional transplantation of glycerin-preserved human amniotic membrane. In 3 months of follow-up, all control corneas were revascularized to the center with granuloma and retained a conjunctival epithelial phenotype. In contrast, five corneas in the experimental group became clear with either minimal or no vascularization; the rest had either mid peripheral (n = 5) or total (n = 3) vascularization and cloudier stroma. The success of corneal surface reconstruction correlated with the return of a cornea-like epithelial phenotype and the preservation of amniotic membrane, whereas the failure maintained a conjunctival epithelial phenotype and the amniotic membrane was either partially degraded or covered by host fibrovascular stroma. These results suggest that measures taken to facilitate epithelialization without allowing host fibrovascular ingrowth onto the amniotic membrane might prove this procedure clinically useful for ocular surface reconstruction.