June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Comparison of Chemical and Photo-Crosslinked Amniotic Membrane with Cryopreserved Amniotic Membrane for the Treatment of Severe Exposure Keratopathy in the New Zealand White Rabbit
Author Affiliations & Notes
  • Hong Zhu
    Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA
  • Anthony J. Johnson
    Research, United States Army Institute of Surgical Research, Fort Sam Houston, TX
  • Andrew Lewis
    Research, San Antonio Military Medical Center, Fort Sam Houston, TX
  • sheri DeMartelaere
    Research, San Antonio Military Medical Center, Fort Sam Houston, TX
  • Raymond Cho
    Research, San Antonio Military Medical Center, Fort Sam Houston, TX
  • Mirang Kim
    Research, United States Army Institute of Surgical Research, Fort Sam Houston, TX
  • Heuy-Ching Wang
    Research, United States Army Institute of Surgical Research, Fort Sam Houston, TX
  • Irene E Kochevar
    Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA
  • Footnotes
    Commercial Relationships Hong Zhu, None; Anthony Johnson, None; Andrew Lewis, None; sheri DeMartelaere, None; Raymond Cho, None; Mirang Kim, None; Heuy-Ching Wang, None; Irene Kochevar, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 735. doi:
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      Hong Zhu, Anthony J. Johnson, Andrew Lewis, sheri DeMartelaere, Raymond Cho, Mirang Kim, Heuy-Ching Wang, Irene E Kochevar; Comparison of Chemical and Photo-Crosslinked Amniotic Membrane with Cryopreserved Amniotic Membrane for the Treatment of Severe Exposure Keratopathy in the New Zealand White Rabbit. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):735.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Due to its anti-inflammatory properties, amniotic membrane has developed into a mainstay of treatment of patients with exposure keratopathy due to burns, to help maintain the ocular surface when skin grafting is delayed. However, due to a host of factors, to include elevated room temperature, desiccation, and inflammatory cytokines in the tear film, the amniotic membrane breaks down rapidly, lasting only 1-3 days. Utilizing our previously described exposure keratopathy model, this study utilized two methods to crosslink amniotic membrane to determine if it was possible to increase its resistance to degradation without reducing its anti-inflammatory properties.

Methods: Thirty-six New Zealand White Rabbits were included in this study. Utilizing our previously reported model of exposure keratopathy, the right upper and lower eyelids were subjected to maximal blepharoplasty and the nictitating membrane was removed. One week following the rabbit was returned to the operating room where cryopreserved amniotic membrane, diimide covalently crosslinked or rose Bengal photocrosslinked amniotic membrane was draped over the cornea and sutured to the limbal conjunctiva and followed for 28 days (n=12) for each arm. The rabbits were returned to the operating room to resuture, patch or replace the amniotic membrane whenever exposure occurred. Histopathological analysis, as well as the number and type of procedures were recorded for each rabbit. Additionally chemokine/ cytokine tear film analysis was conducted using the multiplex immunoassay.

Results: HIstopathological analysis was performed using a 5 point grading system. The results were then analyzed utilizing an ANOVA with Tukey adjustment. Preliminary results revealed no significant difference between the groups. Additionally Kaplan survival analysis was performed to evaluate the degradation of the amniotic membranes. Both crosslinked membranes performed statistically better than the native amniotic membranes. MMP-9 levels were not statistically different between the groups.

Conclusions: Moderate amounts of crosslinking (diimide covalent crosslinking or rose Bengal photocrosslinking) of amniotic membrane appears to improve its ability to withstand degradation, and reduce surgical interventions, while not sacrificing its inherent anti-inflammatory properties.

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