The Efficacy of Amniotic Membrane Graft with Adhesiolysis in Experimentally Induced Lid Adhesion in Rabbits

ABSTRACT

PURPOSE: We investigated the usefulness of subsequent amniotic membrane transplantation following adhesiolysis in preventing readhesion and improving the results of surgery. METHODS: Primary blepharoplasty was done on both eyelids of 8 albino rabbits. After 2 weeks, a new skin incision was made and adhesiolysis was done on both eyelids. The rabbits were categorized into two groups, one with adhesiolysis alone in left eyelids (control), and the other with adhesiolysis with AM graft in right eyelids (AM graft). In the AM graft group, the 15 x 4-mm sized amniotic membrane was designed and transplanted between tarsal plate, orbicularis muscle and subcutaneous tissue with 8-0 Vicryl suture (4 points). The skin was sutured with 6-0 nylon. The rabbits were sacrificed at 1, 2, 4 and 8 weeks after operation, at which time the change of lid shape, inflammation and fibrosis were evaluated. The degree of inflammatory cell infiltration was examined on H & E stain and Masson-trichrome stain was performed to evaluate the degree of fibrosis. RESULTS: On eyelid examination directly after the operation, lid traction was detected in both groups, but after 1 week, the shape of the eyelids had recovered completely in both groups. At 8 weeks, the control group showed more irregular lid margin and surfaces than AM graft group. In microscpic findings at 2 weeks, the AM graft group showed more inflammatory cell infiltration than the control group. At 4 weeks, amniotic membranes were absorbed and inflammatory cell infiltration decreased in both groups, but the AM graft group showed more inflammation than the control group. At 8 weeks, the two groups had little inflammation but the AM graft group showed less fibrosis than the control group on Masson-trichrome stain. CONCLUSIONS: From these findings, we suggest that the use of amniotic membrane graft after adhesiolysis and blepharoplasty is an effective method for prevention of postoperative adhesion.