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The use of amniotic membranes (tissue from the amnion of the placenta) in medicine dates back to more than a century. However, it was just in the past few years, however, that sutureless amniotic membranes came to the ophthalmic community for use in office based eyecare. What is an amniotic membrane and why would you ever want one in your eye?

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Amniotic membranes are derived from the donated placenta of live c-section procedures. The properties of this tissue make it unique and do not have to be tissue-matched like cornea transplants. The healing properties of amniotic membranes can go a long way to make up for poor healing that is so common in patients whose immune system is compromised from age or inflammatory diseases, such as dry eye or keratoconus or whose corneal stem cells are no longer viable.

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The stem cells that fight diseases and help heal a cornea are at the junction of the white of the eye and the cornea, the clear dome-like structure that covers the iris (colored part of the eye). When chronic inflammation exists, as we see with dry eye or keratoconus, inflammation can become chronic and progressive. The inflammation does not resolve on its own, and just gets worse over time. Sometimes, a bandage contact lens will help, but only if the lens can be worn comfortably and tolerated over a longer period of time to permit healing to occur--days to weeks.

 

The bandage lenses do not have any inherent healing properties, only protection from exposure due to the eyelids not sealing all the way or ocular inflammation. When, a bandage lens cannot be worn to heal the irritated eye, amniotic membrane contact lens (AMCL) use is the next logical step.

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There are two types of AMCL membranes: Freeze Dried and Cryopreserved. 

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Cryopreserved Amniotic Membrane - The cryopreserved (or frozen) type is called ProKera and looks like a thin skin attached to a small plastic ring. The ProKera amniotic membrane is applied directly to the eye and generally well-tolerated while the ring is held in place much like a contact lens. Usually, the healing occurs quickly and may only need to be worn for 5 to 7 days before miraculous healing occurs.

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Dry Amniotic Membrane - The second type of amniotic membrane is freeze dried and looks like a tiny flake of skin. The ARIL and AmbioDisk are two common brands we use in our office. This is placed directly on the cornea and held in place with a bandage contact lens placed directly on top of it. The wearing and healing times are similiar to the ProKera.

 

Both of these types of AMCL's work very well when the clinical situation calls for it such as for dry eye, surface inflammation and scarring from keratoconus and other corneal and conjunctival diseases. For dry, irritated eyes, this can be a game changer and permit a leap forward on corneal healing and health. As an optometric cornea specialist, I have used amniotic membranes many times and have seen first hand the amazing healing and scar reduction effects of this novel therapy.

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Call Dr. Scheno @ 516.409.2020 to set up a consultation to see if the AMCL treatment is right for your situation.

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