title: A controlled study of the role of cryopreserved amniotic membrane transplant during strabismus reoperations.
abstract: OBJECTIVE
  To evaluate the effects of using cryopreserved human amniotic membrane (AM) transplant during strabismus reoperations.
  
  
  METHODS
  A total of 30 patients with persistent strabismus were included in this prospective study. Patients were divided into two groups of 15 patients each. The AM group underwent strabismus reoperation with wrapping of the muscles with cryopreserved amniotic membrane. Controls underwent strabismus reoperation without an AM wrap. Final follow-up visit was scheduled between 3 and 12 months postoperatively. Surgical success was defined as 0Δ-10Δof horizontal tropia and 0Δ-4Δof vertical tropia, with no limitation of ductions exceeding -1. A cosmetically acceptable outcome was defined as a tropia of 0Δ-15Δ.
  
  
  RESULTS
  Three patients were excluded in the AM group due to incomplete follow-up. A successful outcome was achieved in 7 patients in each group (58% and 47% in groups AM and C, resp.; P = 0.63). A cosmetically acceptable outcome was achieved in 10 patients in the AM group (83.3%) and 12 (80%) in the control group (P = 0.48). The mean ocular deviation angles improved to 8.7Δ± 12Δin the AM group and 12.3Δ± 17.4Δin the control group (P = 0.63). Ductions improved in 66.7% and 36.4% of the muscles with limited motility in groups AM and C, respectively (P = 0.019).
  
  
  CONCLUSIONS
  Wrapping the extraocular muscles with cryopreserved AM during strabismus reoperations was of limited clinical benefit. We attributed this to the small segment of AM used and to the presence of other causes of failure rather than adhesions.
authors.affiliation: Ophthalmology Department, Cairo University, Cairo, Egypt. Electronic address: rehabrkassem@hotmail.com.
authors.forename: Rehab Rashad
authors.initials: RR
authors.lastname: Kassem
authors.affiliation: Ophthalmology Department, Cairo University, Cairo, Egypt.
authors.forename: Ahmed Mostafa
authors.initials: AM
authors.lastname: Kamal
authors.affiliation: Ophthalmology Department, Cairo University, Cairo, Egypt.
authors.forename: Randa Mohamed Abdel-Moneim
authors.initials: RMA
authors.lastname: El-Mofty
authors.affiliation: Ophthalmology Department, Cairo University, Cairo, Egypt.
authors.forename: Hala Mostafa
authors.initials: HM
authors.lastname: Elhilali
mesh_terms: D000293:Adolescent; D000650:Amnion / Q000637:transplantation*; D015925:Cryopreservation; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D012086:Reoperation; D013285:Strabismus / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*; D016896:Treatment Outcome; D014792:Visual Acuity