Amniotic Membrane Graft, Stem Cell Transplant, Corneal Epithelial Defects

The following terms are often used interchangeably. Amniotic Membrane Graft, Stem Cell Transplant, for treating Corneal Epithelial Defects

Amniotic Membrane -Basic Concepts

Amniotic membrane is used by Dr. Duplessie to protect, repair and heal damaged eye surfaces

How Does Amniotic Membrane Transplantation Work?

 Amniotic membrane works by providing and underlying structure called basement membrane which permits normal skin or conjunctiva to grow on it. It does this by reducing inflammation and scarring.  It also reduces the formation of new blood vessels which cause only problems in the cornea.

Amniotic Membrane Transplantation Limitations:

 The following may complicate the survival of your amniotic membrane transplant

  • Extreme dry eye
  • Severe lack of blood flow
  • Severe lack of stem cells

 

Clinical Uses of Amniotic Membrane Transplantation

Amniotic Membrane Used as a Temporary Graft

Major Action of Amniotic stem cell transplant:

Can help suppress undesirable inflammation but severe inflammation may require the use of multiple sequential amniotic grafts.  The end result is for surface healing without pain or scarring.

Indications for amniotic transplantation:
  •  Acute chemical burns
  •   Acute Stevens Johnson syndrome

    amniotic membrane,Amniotic Membrane Graft, Stem Cell Transplant, Corneal Epithelial Defects

    Helps restore normal skin to the damaged cornea

  •  High-risk Corneal Transplants
  •   Severe keratitis or limbitis with or without stromal ulceration –HSV, HZO, Vernal, Phlyctenular
  •   Post Eximer laser ablation in Phototherapeutic keratectomy

 

 Amniotic Membrane Used as a Permanent Graft for Corneal Surface Reconstruction

Major Action of Amniotic Stem cell transplant:

Restores corneal integrity by replacing the basement membrane which contributes to corneal skin growth and reduces inflammation and scarring during healing.

 

Amniotic Membrane Graft, Stem Cell Transplant, Corneal Epithelial Defects, Dr Michael Duplessie MD

Prokera

 

Indications for amniotic stem cell transplantation:

  •   Painful bullous keratopathy

    Amniotic Membrane Graft, Stem Cell Transplant, Corneal Epithelial Defects

    Helps with the blisters associated with corneal swelling

  •   Band keratopathy
  •   Persistent corneal epithelial defect, ulcer, decemetocele, orperforation
  •   Non-healing neurotrophic ulcers

 Amniotic Membrane Used a Permanent Graft for Conjunctival Surface Reconstruction

Major Action:

To restore the conjunctival after severe damage from disease, infection, inflammation or surgery.

Indications for Amniotic transplant of Conjunctiva:

  •   Benign (pinguecula) or dysplastic or malignant tumors
  •   Pterygium (primary or recurrent, single-headed or double-headed)

    Pterygium, Amniotic Membrane Graft, Stem Cell Transplant, Corneal Epithelial Defects

    Helps prevent recurrence

  •   Symblepharon
  •   Conjunctivochalasis
  •   Superior limbic keratoconjunctivitis
  •   Leaking, cystic or infected blebs
  •   Obliterated fornix (contracted sockets)
  •   With or without scleral melt
  •   With or without implant extrusion

 Amniotic Membrane Used for Reinforcing Tenon’s Capsule

Major Action:

To restore the subconjunctival Tenon’s capsule been weakened or damaged by the disease

Indications:
  •   Conjunctivochalasis
  •   Superior limbic keratoconjunctivitis
  •   Fat prolapse

 

Amniotic Membrane Transplantation with Other Procedures

  • With fibrin glue most commonly in Pterygium surgery.  Helps prevent recurrence.
  •   With Intraoperative Application of Mitomycin C: Helps prevent recurrence
  •   With Tenonplasty- To reduce stromal ischemia and necrosis
  •   With Other Grafts- To reduce the size of the graft otherwise needed