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3/16/2018 1 Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty

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Page 1: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

3/16/2018

1

Cairo University

Placental

membrane

Maternal Fetal

Chorion Amniotic m.

2018 Ayman El-Shiaty

Page 2: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

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

Page 3: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

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

Page 4: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

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

Page 5: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

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

Page 6: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

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

Page 7: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

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

Page 8: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

3/16/2018

8

Cross linking

AMT

2018 Ayman El-Shiaty

6 Ws 3 Ms

2018 Ayman El-Shiaty

Page 9: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

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

Page 10: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

3/16/2018

10

Four months

CF

Scarring

PCO

PK

One week

2018 Ayman El-Shiaty

Two months

Two weeks

2018 Ayman El-Shiaty

Page 11: Cairo University - EOS Egypt · Cairo University Placental membrane Maternal Fetal Chorion Amniotic m. 2018 Ayman El-Shiaty. 3/16/2018 2 Epith cells

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