[Amniotic membrane utilization in ophthalmological surgical procedures]

Abstract

The amniotic membrane, which is the innermost layer of the fetal membranes, is composed of a single layer of epithelial cells that lie on a basement membrane, and of a non-vascular collagenous stroma. These three components give the amniotic membrane its beneficial properties. The first therapeutic application of the amniotic membrane was in 1910, when it was used in skin transplantation. Thereafter, it was used in surgical procedures related to the abdomen, genitourinary tract and to the head and neck. In ophthalmology, De Roth, in 1940, was the first to use the amniotic membrane for conjunctival reconstruction. However, it was only in 1995 that publications on the subject started appearing again, when Tseng and many others began using the amniotic membrane again in the treatment of ocular surface (cornea and conjunctiva) diseases. In cases of total stem cell deficiency, amniotic membrane transplantation has been shown to be very useful when used in conjunction with limbal autografts or allografts. At this stage, however, further studies are needed to elucidate the real potential of the amniotic membrane in the treatment of different ocular surface (and other) disorders, and its exact mechanism(s) of action. This will help establish the applications of such treatment in medicine, in general, and in ophthalmology, in particular.