Focusing on Strabismus

A team of researchers detail in a new report how they wrapped the extraocular muscles of the eye with a specialized placental tissue called lyophilized amniotic membrane in a patient undergoing a third attempt at strabismus surgery on both medial rectus muscles.

Strabismus is a disorder in which both eyes do not line up in the same direction when focusing.

Results from the third surgery were not optimal, however, prompting surgeons to perform a fourth procedure that explored the medial rectus muscles (the eye muscles that help the eyes turn inward towards the nose). There, instead of finding less scarring, the surgeons found extensive adhesions and inelastic, fibrotic muscles.

Unfortunately, postoperative adhesions (bands of scar-like tissue that form between two
surfaces) are a major problem following strabismus surgeries. Amniotic membrane has been used in these surgeries in the aim of preventing adhesions by forming a biological barrier; however, the results from this study indicate the opposite may have occurred.

Surgeon Rehab Kassem, MD, questioned what caused the fibrosis (scar tissue), whether it was related to the use of amniotic membrane or sheer coincidence.

He concluded that, although the fibrosis culprit is not clear in this instance, lyophilized amniotic membrane, which is harvested from placental tissue and used to reconstruct the surface of the eye, proved ineffective in protecting against its development.