Lyophilized umbilical cord amniotic membrane in trichiasis surgery: A novel alternative to mucous membrane grafting ?

Abstract

Purpose

Ultra-thick amniotic membrane grafts derived from the umbilical cord have become available recently. We present a case series describing a new reconstructive technique involving an umbilical cord patch for anterior lamellar reconstruction surgery for severe trichiasis as an alternative to mucous membrane grafting.

Methods

This was a single-center, retrospective clinical case series involving 18 eyes from 12 patients who underwent eyelid margin reconstruction using a lyophilized umbilical cord patch. Patients were treated with lid margin splitting and resection of pathological eyelash follicles for various indications, including chronic ocular conjunctivitis, trichiasis, ocular pemphigoid, and trachoma. The follow-up period extended over 15 months.

Results

All patients reported satisfactory tolerance and efficacity. At 1 month, the success rate was 83% (n = 15) and at 12 months, it was 89% (n = 16). The complication rate was 11%, with no major complications as a result of the graft itself.

Conclusion

Lyophilized umbilical cord patches may offer a valuable option for oculoplastic reconstruction. These cases highlight the utility of using an umbilical cord patch containing Wharton's jelly in eyelid trichiasis surgery, which has traditionally required more invasive techniques. This approach may reduce or eliminate the need for buccal mucous membrane grafts, minimize graft-related scarring, and employ a well-tolerated biological material. We propose considering this technique for patients in whom conventional options have failed or are unsuitable.