Page 344 - IJB-9-3

International Journal of Bioprinting Amniotic fornical ring for ocular surface reconstruction

Table 2. Comparison of different outcomes of the patients in two treatment groups
AFR SAMT P
Initial VA (logMAR) 0.959 1.150 0.414
(0.600–1.775) (0.700–2.000)
Final VA (logMAR) 0.300 0.450 0.214
(0.100–0.900) (0.300–1.200)
VA improvement (initial–final) (logMAR) 0.400 0.500 0.688
(0.200–0.900) (0.200–0.800)
Epithelial healing time (days) 14 (7–75) 30 (14–55) 0.386
44 ± 52 40 ± 41 0.751
AM dissolution or removal time (days) 7 (7–19) 14 (7–14) 0.436
15 ± 11 14 ± 7 0.812
The percentage of healed corneal area 90.91% 93.67% 0.994
(66.10%–100.00%) (60.23%–100.00%)
Symblepharon 12 (31.58%) 9 (40.91%) 0.465
Conjunctival granuloma 0 1 (4.55%) 0.407
Limbal stem cell deficiency (LSCD) 12 (31.58%) 12 (54.55%) 0.080
Glaucoma 2 (5.26%) 0 0.508
Cataract 3 (7.89%) 3 (13.64%) 0.961
Abbreviations: AM, amniotic membrane; LSCD, limbal stem cell deficiency; VA, visual acuity.
Table 3. Cost analysis between 3D-printed AFR and SAMT

AFR SAMT P
Cost analysis
Surgeon’s compensation 870.00 968.00 0.037
(734.25–979.00) (870.00–979.00)
Sutures 0.00 128.63 0.000
(0.00–0.00) (122.50–192.94)
Operation room cost 158.65 257.44 0.100
(128.72–257.44) (133.67–267.90)
Anesthesia cost 40.00 129.00 0.001
(36.25–70.00) (58.38–854.63)
Price per 1% area healed 12.79 19.24 0.001
(9.97–16.61) (13.85–36.81)
Operation time (min) 16 (10–24) 35 (30–47) 0.000
18.4 ± 10.1 42.2 ± 18.5 0.000

described for sutureless human amniotic fixation on nature and the presence of amniotic folds. The 3D-printed
the ocular surface. Researchers reported a polymethyl AFR allows the AM to fit to the ocular surface better
methacrylate (PMMA)-based ring for a therapeutic without wrinkles (Figure 2A). Therefore, the advantages
contact lens on the cornea of New Zealand rabbits [18,19] . of 3D-printed AFR include its individual design, easy
However, PMMA material increased the discomfort and bedside insertion without the need for sedation, and easy
the risk of ring slipping out. In this study, none of the replacement after AM dissolution.
personalized 3D-printed AFRs automatically slipped out
of the conjunctival sac. Moreover, the 3D-printed AFR Another AMT was required in 15 eyes (37.5%) in the
was easy to replace, similar to a contact lens. A custom- AFR group and in 9 eyes (40.9%) in the SAMT group
made fornical ring with sterile intravenous tubing (IVT) because of earlier AM dissolution. Regarding the cost
could cover the entire mucosal surface and eyelid . The analysis (Table 3), 3D-printed AFRs were provided free of
[10]
disadvantages of the IVT ring include its time-consuming charge. The price of AM changed during the trial, and since

Volume 9 Issue 3 (2023) 336 https://doi.org/10.18063/ijb.713