Amniotic Membrane Transplantation an Experience of a Locally Prepared Tissue

Abstract

Purpose: To describe the method used locally in amniotic membrane preparation and preservation for ocular surface reconstruction. To report the indications, surgical techniques, outcome and complications of amniotic membrane transplant using the locally prepared tissue. To examine the safety and efficacy of this less commonly studied method in amniotic membrane banking technique. Patients and Methods: Dimethylsulphoxide (DMSO) was used for the preparation and preservation of the amniotic membrane. A retrospective study was done from 2005 to 2017 to examine the indications of amniotic membrane transplant. The surgical techniques used for different indications are described. Surgical outcome and complications are reported. Results: The prepared tissue was used for the surgical management of a variety of disorders related to the ocular surface. Over the 12 years period from 2005 to 2017, a total of 135 cases were done. The most common indications for amniotic membrane transplant were pterygium surgery (41%), non-healing corneal ulcer (24%), others (13%), corneal perforation (10%), chemical burn (7%), bullous keratopathy (3%) and conjunctival-corneal scarring (2%). The most common surgical procedures used were inlay, overlay and combination (sandwich) techniques. Success rates for this ocular structure restoration procedure were the highest when treating corneal ulcers (81%), followed by pseudophakic bullous keratopathy (75%), then corneal perforations (70%). The recurrence rate for pterygium with amniotic membrane transplant was 14%. The most common complication was repeat amniotic membrane transplant. There were no complications related to the banking technique. Conclusion: This method of preparation and preservation of amniotic membranes is safe and effective for ocular surface disorders. Amniotic membrane transplants have high success rates when treating, corneal ulcers, corneal perforations, pseudophakic bullous and epidermolysis bullosa.