Amniotic membranes in ophthalmology: long term data on transplantation outcomes

Abstract

The use of amniotic membrane (AM) is a widespread clinical practice for eye surgeries and the treatment of an increasing number of ocular surface pathologies. Here we describe the AM collection methods and donor selection criteria adopted by our tissue bank to distribute 5349 amniotic membrane patches over the last 12 years for the treatment of several ocular pathologies. Specific quality control measures are described and the long term results attained using the reported procedure are presented. A case of AM utilized to treat severe ocular ulceration is also described as an example of AM transplantation. Collective data for the total amniotic membrane patches deployed to treat various ocular diseases are discussed and success rates for AM transplantations are reported. An extensive follow-up is illustrated. The results suggest that the procedures and protocols used by the Treviso Tissue Bank Foundation and Veneto Eye Bank Foundation for collection, preservation, distribution and follow-up are of an optimal standard. Accordingly, the authors conclude that the safety and efficiency of the proposed procedure for the therapeutic use of AM to treat various ocular pathologies are reproducible, with additional evidence favoring the use of AM as an alternative to conventional medical treatment for certain ocular conditions.

Keywords: Amniotic membrane; Collection; Distribution; Follow-up; Long term; Preservation.

Fig. 1

Treatment of corneal ulceration using AM. A patient with descemetocele white arrow caused by recurring HK (a). AM transplantation was performed and the gap was filled with membrane and glue (b). Images taken few weeks after filling and grafting. After AM grafting, penetrating keratoplasty was performed (c)