cairo university - eos egypt · cairo university placental membrane maternal fetal chorion amniotic...
TRANSCRIPT
3/16/2018
1
Cairo University
Placental
membrane
Maternal Fetal
Chorion Amniotic m.
2018 Ayman El-Shiaty
3/16/2018
2
Epith cellsBM• Thick
• Collagen IV, V, VII
• Fibronectin&laminin
Matrix• Hyaluronic a
• Protease inhibitors
2018 Ayman El-Shiaty
Epith cells
BM
Matrix
• Thick
• Collagen IV, V, VII
• Fibronectin&laminin
• Hyaluronic a
• Protease inhibitors
Epith Supporting substrate
Conj epith differentiation
- - TGF-ᵝ & myofibroblast
Inflammatory cell apoptosis
2018 Ayman El-Shiaty
3/16/2018
3
Rotth, 1940...........Amnion&Chorion
Sorsby, 1946..............Amnioplastin
Kim&Tseng, 1995......Cryopreserved
2018 Ayman El-Shiaty
+
Keratoprosthesis
Dry eye
Corneal perforation
2018 Ayman El-Shiaty
3/16/2018
4
Inlay Graft
Overlay
Patch (CL)
Ex-vivo
expansion of SC
Promotes epithelialization
Healing epith
Non scarring microenvironment
Protects damaged SC
Inf mediators in tears from stroma
ECM substrate
SC carrier
2018 Ayman El-Shiaty
Inlay Graft
Overlay
Patch (CL)
Filling
2018 Ayman El-Shiaty
3/16/2018
5
2018 Ayman El-Shiaty
Un-guided ttt for 1/12
Trauma ??
C/S (S.aureus) guided ttt 3/12
Filling+Inlay grafts
2018 Ayman El-Shiaty
3/16/2018
6
Stick trauma
Perforation
Filling + Inlay + onlay grafts
C&S (Aspergillus) guided ttt
2018 Ayman El-Shiaty
Amniotic Membrane Transplantation
Promotes Epithelialization
Substrate for subsequent limbal transplantation
SC protector and carrier
Reduces inflammation and scarring
Antimicrobial effect ??
Tectonic
2018 Ayman El-Shiaty
3/16/2018
7
Aetiology
Viral infection
Bacterial infection
Fungal infection
Acanthameba
Non-infectious
Engineer 52 ys
Heavy smoker
Pain & DV for 2/52
AB
Progressive
HM
Fusarium solani
2018 Ayman El-Shiaty
Topical natamycin 5%
Systemic vfend 200 mg bid Infection better
Corneal melting
2018 Ayman El-Shiaty
3/16/2018
8
Cross linking
AMT
2018 Ayman El-Shiaty
6 Ws 3 Ms
2018 Ayman El-Shiaty
3/16/2018
9
One week
PK+CE+IOL
2018 Ayman El-Shiaty
Two weeks One month
Two months
IOP +++ in spite of full
medical treatment
TSCPCx2=12mmHg
2018 Ayman El-Shiaty
3/16/2018
10
Four months
CF
Scarring
PCO
PK
One week
2018 Ayman El-Shiaty
Two months
Two weeks
2018 Ayman El-Shiaty
3/16/2018
11
Three months
3/60
18 mmHgYAG capsulotomy
One year 6/36
19 mmHg
2018 Ayman El-Shiaty
2018 Ayman El-Shiaty