cairo university - eos egypt cairo university placental membrane maternal fetal chorion amniotic m

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  • 3/16/2018

    1

    Cairo University

    Placental

    membrane

    Maternal Fetal

    Chorion Amniotic m.

    2018 Ayman El-Shiaty

  • 3/16/2018

    2

    Epith cells BM• 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

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