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. 1999 Jun;83(6):748–752. doi: 10.1136/bjo.83.6.748

Amniotic membrane transplantation

H DUA
PMCID: PMC1723092  PMID: 10340988

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Figure 1  .

Figure 1  

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Transmission electron microscopy of the amnion. The apical border of the amniotic epithelial cells contains a great number of microvilli. The cytoplasm contains numerous vesicles. Basal cell processes (pedicels) extend into the basement membrane. The underlying connective tissue has a homogeneous structure.

Figure 2  .

Figure 2  

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Surgical technique. The diagram illustrates the amniotic membrane sutured to the cornea and covering a paracentral corneal epithelial defect.

Figure 3  .

Figure 3  

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Surgical technique. The amniotic membrane is sutured to perilimbal episclera and to the edge of the conjunctiva (after peritomy) covering the whole corneal surface.

Figure 4  .

Figure 4  

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Surgical technique. The amniotic membrane can be used to cover a conjunctival defect after releasing adhesions during symblepharon surgery, and in a similar manner (nasally or temporally) after excision of pterygium.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adinolfi M., Akle C. A., McColl I., Fensom A. H., Tansley L., Connolly P., Hsi B. L., Faulk W. P., Travers P., Bodmer W. F. Expression of HLA antigens, beta 2-microglobulin and enzymes by human amniotic epithelial cells. Nature. 1982 Jan 28;295(5847):325–327. doi: 10.1038/295325a0. [DOI] [PubMed] [Google Scholar]
  2. Akle C. A., Adinolfi M., Welsh K. I., Leibowitz S., McColl I. Immunogenicity of human amniotic epithelial cells after transplantation into volunteers. Lancet. 1981 Nov 7;2(8254):1003–1005. doi: 10.1016/s0140-6736(81)91212-5. [DOI] [PubMed] [Google Scholar]
  3. Arora M., Jaroudi K. A., Hamilton C. J., Dayel F. Controlled comparison of interceed and amniotic membrane graft in the prevention of postoperative adhesions in the rabbit uterine horn model. Eur J Obstet Gynecol Reprod Biol. 1994 Jun 30;55(3):179–182. doi: 10.1016/0028-2243(94)90035-3. [DOI] [PubMed] [Google Scholar]
  4. Azuara-Blanco A., Katz L. J. Dysfunctional filtering blebs. Surv Ophthalmol. 1998 Sep-Oct;43(2):93–126. doi: 10.1016/s0039-6257(98)00025-3. [DOI] [PubMed] [Google Scholar]
  5. Azuara-Blanco A., Pillai C. T., Dua H. S. Amniotic membrane transplantation for ocular surface reconstruction. Br J Ophthalmol. 1999 Apr;83(4):399–402. doi: 10.1136/bjo.83.4.399. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Boudreau N., Sympson C. J., Werb Z., Bissell M. J. Suppression of ICE and apoptosis in mammary epithelial cells by extracellular matrix. Science. 1995 Feb 10;267(5199):891–893. doi: 10.1126/science.7531366. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Colocho G., Graham W. P., 3rd, Greene A. E., Matheson D. W., Lynch D. Human amniotic membrane as a physiologic wound dressing. Arch Surg. 1974 Sep;109(3):370–373. doi: 10.1001/archsurg.1974.01360030022006. [DOI] [PubMed] [Google Scholar]
  8. Dhall K. Amnion graft for treatment of congenital absence of the vagina. Br J Obstet Gynaecol. 1984 Mar;91(3):279–282. doi: 10.1111/j.1471-0528.1984.tb04768.x. [DOI] [PubMed] [Google Scholar]
  9. Dua H. S., Azuara-Blanco A. Allo-limbal transplantation in patients with limbal stem cell deficiency. Br J Ophthalmol. 1999 Apr;83(4):414–419. doi: 10.1136/bjo.83.4.414. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Dua H. S., Forrester J. V. The corneoscleral limbus in human corneal epithelial wound healing. Am J Ophthalmol. 1990 Dec 15;110(6):646–656. doi: 10.1016/s0002-9394(14)77062-x. [DOI] [PubMed] [Google Scholar]
  11. Dua H. S., Gomes J. A., Singh A. Corneal epithelial wound healing. Br J Ophthalmol. 1994 May;78(5):401–408. doi: 10.1136/bjo.78.5.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Dua H. S. The conjunctiva in corneal epithelial wound healing. Br J Ophthalmol. 1998 Dec;82(12):1407–1411. doi: 10.1136/bjo.82.12.1407. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Faulk W. P., Matthews R., Stevens P. J., Bennett J. P., Burgos H., Hsi B. L. Human amnion as an adjunct in wound healing. Lancet. 1980 May 31;1(8179):1156–1158. doi: 10.1016/s0140-6736(80)91617-7. [DOI] [PubMed] [Google Scholar]
  14. Fujishima H., Shimazaki J., Shinozaki N., Tsubota K. Trabeculectomy with the use of amniotic membrane for uncontrollable glaucoma. Ophthalmic Surg Lasers. 1998 May;29(5):428–431. [PubMed] [Google Scholar]
  15. Gruss J. S., Jirsch D. W. Human amniotic membrane: a versatile wound dressing. Can Med Assoc J. 1978 May 20;118(10):1237–1246. [PMC free article] [PubMed] [Google Scholar]
  16. Guo M., Grinnell F. Basement membrane and human epidermal differentiation in vitro. J Invest Dermatol. 1989 Sep;93(3):372–378. [PubMed] [Google Scholar]
  17. Holland E. J., Schwartz G. S. The evolution of epithelial transplantation for severe ocular surface disease and a proposed classification system. Cornea. 1996 Nov;15(6):549–556. [PubMed] [Google Scholar]
  18. Kenyon K. R., Tseng S. C. Limbal autograft transplantation for ocular surface disorders. Ophthalmology. 1989 May;96(5):709–723. doi: 10.1016/s0161-6420(89)32833-8. [DOI] [PubMed] [Google Scholar]
  19. Khodadoust A. A., Silverstein A. M., Kenyon D. R., Dowling J. E. Adhesion of regenerating corneal epithelium. The role of basement membrane. Am J Ophthalmol. 1968 Mar;65(3):339–348. doi: 10.1016/0002-9394(68)93082-1. [DOI] [PubMed] [Google Scholar]
  20. Kurpakus M. A., Stock E. L., Jones J. C. The role of the basement membrane in differential expression of keratin proteins in epithelial cells. Dev Biol. 1992 Apr;150(2):243–255. doi: 10.1016/0012-1606(92)90239-d. [DOI] [PubMed] [Google Scholar]
  21. Lee S. H., Tseng S. C. Amniotic membrane transplantation for persistent epithelial defects with ulceration. Am J Ophthalmol. 1997 Mar;123(3):303–312. doi: 10.1016/s0002-9394(14)70125-4. [DOI] [PubMed] [Google Scholar]
  22. Li D. Q., Tseng S. C. Three patterns of cytokine expression potentially involved in epithelial-fibroblast interactions of human ocular surface. J Cell Physiol. 1995 Apr;163(1):61–79. doi: 10.1002/jcp.1041630108. [DOI] [PubMed] [Google Scholar]
  23. Nisolle M., Donnez J. Vaginoplasty using amniotic membranes in cases of vaginal agenesis or after vaginectomy. J Gynecol Surg. 1992 Spring;8(1):25–30. doi: 10.1089/gyn.1992.8.25. [DOI] [PubMed] [Google Scholar]
  24. Pollard S. M., Aye N. N., Symonds E. M. Scanning electron microscope appearances of normal human amnion and umbilical cord at term. Br J Obstet Gynaecol. 1976 Jun;83(6):470–477. doi: 10.1111/j.1471-0528.1976.tb00868.x. [DOI] [PubMed] [Google Scholar]
  25. Prabhasawat P., Barton K., Burkett G., Tseng S. C. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology. 1997 Jun;104(6):974–985. doi: 10.1016/s0161-6420(97)30197-3. [DOI] [PubMed] [Google Scholar]
  26. Prasad J. K., Feller I., Thomson P. D. Use of amnion for the treatment of Stevens-Johnson syndrome. J Trauma. 1986 Oct;26(10):945–946. doi: 10.1097/00005373-198610000-00016. [DOI] [PubMed] [Google Scholar]
  27. Rennekampff H. O., Dohrmann P., Föry R., Fändrich F. Evaluation of amniotic membrane as adhesion prophylaxis in a novel surgical gastroschisis model. J Invest Surg. 1994 May-Jun;7(3):187–193. doi: 10.3109/08941939409018285. [DOI] [PubMed] [Google Scholar]
  28. Shimazaki J., Shinozaki N., Tsubota K. Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon. Br J Ophthalmol. 1998 Mar;82(3):235–240. doi: 10.1136/bjo.82.3.235. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Shimazaki J., Yang H. Y., Tsubota K. Amniotic membrane transplantation for ocular surface reconstruction in patients with chemical and thermal burns. Ophthalmology. 1997 Dec;104(12):2068–2076. doi: 10.1016/s0161-6420(97)30057-8. [DOI] [PubMed] [Google Scholar]
  30. Sorsby A., Haythorne J., Reed H. FURTHER EXPERIENCE WITH AMNIOTIC MEMBRANE GRAFTS IN CAUSTIC BURNS OF THE EYE. Br J Ophthalmol. 1947 Jul;31(7):409–418. doi: 10.1136/bjo.31.7.409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Sorsby A., Symons H. M. AMNIOTIC MEMBRANE GRAFTS IN CAUSTIC BURNS OF THE EYE: (Burns of the second degree). Br J Ophthalmol. 1946 Jun;30(6):337–345. [PMC free article] [PubMed] [Google Scholar]
  32. Subrahmanyam M. Amniotic membrane as a cover for microskin grafts. Br J Plast Surg. 1995 Oct;48(7):477–478. doi: 10.1016/0007-1226(95)90123-x. [DOI] [PubMed] [Google Scholar]
  33. TROENSEGAARD-HANSEN E. Amniotic grafts in chronic skin ulceration. Lancet. 1950 May 6;1(6610):859–860. doi: 10.1016/s0140-6736(50)90693-3. [DOI] [PubMed] [Google Scholar]
  34. Talmi Y. P., Sigler L., Inge E., Finkelstein Y., Zohar Y. Antibacterial properties of human amniotic membranes. Placenta. 1991 May-Jun;12(3):285–288. doi: 10.1016/0143-4004(91)90010-d. [DOI] [PubMed] [Google Scholar]
  35. Tan D. T., Ficker L. A., Buckley R. J. Limbal transplantation. Ophthalmology. 1996 Jan;103(1):29–36. doi: 10.1016/s0161-6420(96)30737-9. [DOI] [PubMed] [Google Scholar]
  36. Terranova V. P., Lyall R. M. Chemotaxis of human gingival epithelial cells to laminin. A mechanism for epithelial cell apical migration. J Periodontol. 1986 May;57(5):311–317. doi: 10.1902/jop.1986.57.5.311. [DOI] [PubMed] [Google Scholar]
  37. Tsai R. J., Tseng S. C. Human allograft limbal transplantation for corneal surface reconstruction. Cornea. 1994 Sep;13(5):389–400. doi: 10.1097/00003226-199409000-00003. [DOI] [PubMed] [Google Scholar]
  38. Tseng S. C., Prabhasawat P., Barton K., Gray T., Meller D. Amniotic membrane transplantation with or without limbal allografts for corneal surface reconstruction in patients with limbal stem cell deficiency. Arch Ophthalmol. 1998 Apr;116(4):431–441. doi: 10.1001/archopht.116.4.431. [DOI] [PubMed] [Google Scholar]
  39. Tseng S. C., Prabhasawat P., Lee S. H. Amniotic membrane transplantation for conjunctival surface reconstruction. Am J Ophthalmol. 1997 Dec;124(6):765–774. doi: 10.1016/s0002-9394(14)71693-9. [DOI] [PubMed] [Google Scholar]
  40. Tsubota K., Satake Y., Ohyama M., Toda I., Takano Y., Ono M., Shinozaki N., Shimazaki J. Surgical reconstruction of the ocular surface in advanced ocular cicatricial pemphigoid and Stevens-Johnson syndrome. Am J Ophthalmol. 1996 Jul;122(1):38–52. doi: 10.1016/s0002-9394(14)71962-2. [DOI] [PubMed] [Google Scholar]
  41. Tsubota K., Toda I., Saito H., Shinozaki N., Shimazaki J. Reconstruction of the corneal epithelium by limbal allograft transplantation for severe ocular surface disorders. Ophthalmology. 1995 Oct;102(10):1486–1496. doi: 10.1016/s0161-6420(95)30841-x. [DOI] [PubMed] [Google Scholar]
  42. Ward D. J., Bennett J. P., Burgos H., Fabre J. The healing of chronic venous leg ulcers with prepared human amnion. Br J Plast Surg. 1989 Jul;42(4):463–467. doi: 10.1016/0007-1226(89)90015-5. [DOI] [PubMed] [Google Scholar]
  43. Ward D. J., Bennett J. P. The long-term results of the use of human amnion in the treatment of leg ulcers. Br J Plast Surg. 1984 Apr;37(2):191–193. doi: 10.1016/0007-1226(84)90009-2. [DOI] [PubMed] [Google Scholar]
  44. van Herendael B. J., Oberti C., Brosens I. Microanatomy of the human amniotic membranes. A light microscopic, transmission, and scanning electron microscopic study. Am J Obstet Gynecol. 1978 Aug 15;131(8):872–880. doi: 10.1016/s0002-9378(16)33135-0. [DOI] [PubMed] [Google Scholar]

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