Podcast
Questions and Answers
What was the outcome at the end of three months after the use of amniotic membrane graft?
What was the outcome at the end of three months after the use of amniotic membrane graft?
Which of the following is a primary application of human amniotic membrane transplantation?
Which of the following is a primary application of human amniotic membrane transplantation?
What does the reference by Malhotra C and Jain AK focus on?
What does the reference by Malhotra C and Jain AK focus on?
What is indicated by the term 'serial photographs' in the context of amniotic membrane graft study?
What is indicated by the term 'serial photographs' in the context of amniotic membrane graft study?
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What is a key advantage of using human amniotic membrane in ophthalmology?
What is a key advantage of using human amniotic membrane in ophthalmology?
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What aspect of amniotic membrane grafts was particularly noted after three months?
What aspect of amniotic membrane grafts was particularly noted after three months?
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Which of the following best describes the duration for observing the results of the amniotic membrane graft?
Which of the following best describes the duration for observing the results of the amniotic membrane graft?
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What occurs during the latent phase of corneal wound healing?
What occurs during the latent phase of corneal wound healing?
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Which factor plays a significant role in the proliferation phase of corneal wound healing?
Which factor plays a significant role in the proliferation phase of corneal wound healing?
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What is a key reason for using amniotic membrane in corneal treatments?
What is a key reason for using amniotic membrane in corneal treatments?
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During which phase do cells firmly adhere to the basement membrane?
During which phase do cells firmly adhere to the basement membrane?
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What is NOT a component found in amniotic membrane?
What is NOT a component found in amniotic membrane?
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Which condition is NOT typically treated with an amniotic membrane?
Which condition is NOT typically treated with an amniotic membrane?
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What is a major consequence of severe chronic inflammation in corneal scarring?
What is a major consequence of severe chronic inflammation in corneal scarring?
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What is the role of antimicrobial proteins like CAP37 during the migration phase?
What is the role of antimicrobial proteins like CAP37 during the migration phase?
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Which statement about amniotic membrane is incorrect?
Which statement about amniotic membrane is incorrect?
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What primarily happens in the migration phase of corneal healing?
What primarily happens in the migration phase of corneal healing?
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Study Notes
Corneal Wound Healing Phases
- Healing involves four distinct phases: latent, migration, proliferation, and attachment.
Latent Phase (First 6 hours)
- Reduction of intracellular junctions and hemidesmosomes, promoting the removal of damaged basal cells.
- Infiltration of neutrophils occurs, along with keratinocyte apoptosis.
Migration Phase (6-36 hours post-injury)
- Epithelial cells begin migrating to close the surface gap.
- Cells start adhering to the basement membrane (BM) with primary neutrophil wave at 18 hours and secondary wave at 30 hours.
- Neutrophils contain antimicrobial proteins (AMPs) for protection.
Proliferation Phase (36-48 hours)
- Basal cells from the columnar layer proliferate, differentiating into wing and superficial cells.
Attachment Phase (48 hours)
- Epithelial cells adhere firmly to the BM, increasing intercellular junctions to prevent separation and restore normal functionality.
Importance of Antimicrobial Peptides (AMPs)
- Present throughout the wound healing process including tear film.
- CAP37 protein plays a key role in antimicrobial defense.
Corneal Scarring
- Severe chronic inflammation, marked by lymphocyte and neutrophil infiltration, leads to fibroblast proliferation and disorganized collagen, resulting in scarring.
- Corneal scarring can lead to low visual acuity (VA).
Amniotic Membrane in Corneal Treatment
- Utilized for corneal ulcers, pterygium, and epithelial damage, promotes corneal regeneration without causing neovascularization.
- Composed of thick basement membrane (BM) derived from placenta, rich in collagen and proteins aiding in keratinocyte proliferation.
Growth Factors in Amniotic Membrane
- Contains signaling molecules such as epidermal growth factor (EGF), transforming growth factor beta (TGFβ), fibroblast growth factor (FGF), and platelet-derived growth factor (PDGF) which promote epithelialization.
Benefits of Amniotic Membrane
- Facilitates quicker epithelial healing and reinforces adhesion while preventing apoptosis and reducing pain.
- FDA-approved PROKERA is a cryopreserved amniotic membrane product.
Clinical Applications of Amniotic Membrane
- Used in treating conditions like exposure keratitis, neurotrophic corneal diseases, bullous keratopathy, persistent corneal epithelial defects, recurrent corneal erosion (RCE), Stevens-Johnson Syndrome (SJS), acute corneal burns, and others.
Coverage and Integration
- Amniotic membrane can completely cover the cornea and allows cell migration from the limbus, promoting healing.
- Successful integration noted in procedures such as covering bare sclera post-pterygium excision with excellent cosmetic results observed after three months.
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Description
Explore the four distinct phases of corneal wound healing: latent, migration, proliferation, and attachment. This quiz delves into the intricate processes involved in each phase and highlights the significance of antimicrobial peptides in wound care.
