Adjunct amniotic membrane during enucleation for retinoblastoma to prevent implant exposure
Reviewed by Fiona Rowe

Amniotic membrane (AM) has potential for treatment of retinoblastoma (RB) patients with contracted sockets after enucleation. The authors present their experience of AM with enucleation for patients with RB after chemotherapy in this retrospective study of 100 eyes of 107 patients. Primary enucleation was required for 77 eyes (70%) and secondary enucleation for the remainder. Systemic chemotherapy was given to 49 patients (45.7%). Other therapies included intra-arterial chemotherapy (IAT: 11.8%), intravitreal chemotherapy (3.6%), subconjunctival chemotherapy (1.8%), plaque brachytherapy (2.7%) and external beam radiation therapy (EBRT: 6.3%). Amniotic membrane graft was used in eight eyes during enucleation and none had implant exposure or wound infection, with average follow-up of 108 weeks (range 40–148). IAC was found to be a significant risk factor for implant exposure. All exposures were in children who did not have a simultaneous AM placement. Advantages reported for AM use were that it is easily available, transparent, non-immunogenic, and has antifibrotic effects and anti-inflammatory effects with improved postoperative healing. Disadvantages are that AM is a biological membrane, is not strong tectonically, and is thin and fragile. The authors conclude AM is a useful adjunct during enucleation surgery to prevent implant extrusion and is of particular benefit for those who receive chemotherapy.

Amniotic membrane augmentation for enucleation after chemotherapy in retinoblastoma.
Ramasubramanian A, Rahman NS, Chauhan A, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2024;61(4):291–5.