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Amniotic membrane in ophthalmology: properties, preparation, storage and indications for grafting—a review

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Abstract

The use of amniotic membrane in ophthalmic surgery and other surgical procedures in the fields of dermatology, plastic surgery, genitourinary medicine and otolaryngology is on the increase. Furthermore, amniotic membrane and its epithelial and mesenchymal cells have broad use in regenerative medicine and hold great promise in anticancer treatment. Amniotic membrane is a rich source of biologically active factors and as such, promotes healing and acts as an effective material for wound dressing. Amniotic membrane supports epithelialization and exhibits anti-fibrotic, anti-inflammatory, anti-angiogenic and anti-microbial features. Placentas utilised in the preparation of amniotic membrane are retrieved from donors undergoing elective caesarean section. Maternal blood must undergo serological screening at the time of donation and, in the absence of advanced diagnostic testing techniques, 6 months postpartum in order to cover the time window for the potential transmission of communicable diseases. Amniotic membrane is prepared by blunt dissection under strict aseptic conditions, then is typically transferred onto a nitrocellulose paper carrier, usually with the epithelial side up, and cut into multiple pieces of different dimensions. Amniotic membrane can be stored under various conditions, most often cryopreserved in glycerol or dimethyl sulfoxide or their mixture with culture medium or buffers. Other preservation methods include lyophilisation and air-drying. In ophthalmology, amniotic membrane is increasingly used for ocular surface reconstruction, including the treatment of persistent epithelial defects and non-healing corneal ulcers, corneal perforations and descemetoceles, bullous keratopathy, as well as corneal disorders with associated limbal stem cell deficiency, pterygium, conjunctival reconstruction, corneoscleral melts and perforations, and glaucoma surgeries.

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Acknowledgements

The research leading to these results has received funding from the Norwegian Financial Mechanism 2009–2014 and the Ministry of Education, Youth and Sports of the Czech Republic under Project Contract no. MSMT-28477/2014, Project 7F14156. The authors thank Dr. Peter Trosan for the preparation of images in Fig. 1b, c.

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  1. Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, General Teaching Hospital and 1st Faculty of Medicine, Charles University, Czech Republic, Ke Karlovu 2, 128 08, Prague 2, Czech Republic

    Katerina Jirsova

  2. The Veneto Eye Bank Foundation, Padiglione Rama - Via Paccagnella n. 11, 30174, Zelarino, Venice, Italy

    Gary L. A. Jones

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  1. Katerina Jirsova
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Correspondence to Katerina Jirsova.

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Method of Literature Search: PubMed/Medline database searches were undertaken in an iterative manner from July 2012 onwards using the key words of placenta and amniotic membrane, together with other specific keywords for each described section (i.e. amniotic membrane plus procurement).

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Jirsova, K., Jones, G.L.A. Amniotic membrane in ophthalmology: properties, preparation, storage and indications for grafting—a review. Cell Tissue Bank 18, 193–204 (2017). https://doi.org/10.1007/s10561-017-9618-5

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