What conditions can be helped with amniotic membranes?

Who is a candidate for amniotic membrane contact lens?

• Amniotic membranes may be an excellent solution for those who have struggled with dry eyes in the past and were unable to find relief through medications or other treatments.
• Amniotic membrane contact lenses may also be suitable for patients who suffer from corneal scarring. The purpose of amniotic membrane is to reduce inflammation, promote healing, and reduce discomfort in the eyes.
• Amniotic membranes may be an option for those who suffer from a neurotrophic ulcer caused by a neurosurgical procedure or viral infection.

What conditions can amniotic membranes be used for?

Amniotic membrane is utilized in post surgical care after surgeries that involve removing eye tissues, including treating chemical burns, corneal ulcers and conjunctival ulcers, as well as diseases that cause painful ulcerations.

In a 12-year study conducted in Italy, 5,349 surgical procedures using amniotic membrane patches were successfully performed. The treatment's effectiveness was evaluated one year after surgery based on the scope of the surgery, resolution of inflammation, relief of symptoms, restoration of regular and stable corneal epithelium, and restoration of the structural integrity of the eye. 

Consequently, the authors of the study concluded that the proposed procedure for the therapeutic use of amniotic membranes to treat various ocular pathologies is reproducible, and that amniotic membranes can be used in place of conventional medical treatment for certain conditions in the ocular system.

Conditions treated using amniotic membranes included: 

• Neurotrophic keratitis
• Keratitis/endophthalmitis
• Pterygium
• Post-keratoplasty, glaucoma or cataract
• Chemical trauma
• Bullous keratopathy
• Neoplasm of the ocular surface
• Reconstruction of the conjunctiva and fornix
• Corneal degeneration
• Recurrent epithelial erosion
• Primary and secondary limbal stem cell deficiency
• Mucous membrane pemphigoid
• Dystrophy
• Mechanical trauma
• Chronic Stevens-Johnson syndrome or Lyell’s syndrome
• Reconstruction of the anophthalmic cavity
• Physical trauma
• Eyelid reconstruction
• Dysfunctional tear syndrome

In this study, partial success was achieved if two criteria were met. If any of these criteria were not met, the result was considered a failure. The study achieved a 100% success rate in treating a variety of conditions, including corneal ulcers and neurotrophic keratitis, as well as post-keratoplasty, glaucoma, cataract, bullous keratopathy, corneal degeneration and dystrophy, mechanical trauma, and reconstructing the anophthalmic cavity and eyelids. Additionally, dysfunctional tears were successfully treated in the study.

Amniotic membranes are underutilized despite their many benefits

Although amniotic membranes have many healing properties and could potentially be widely used in optometry and ophthalmology, data suggests that they have not been widely adopted. According to the information from the Centers for Medicare & Medicaid Services (CMS), only 314 doctors of optometry in the U.S. reported using the HCPCS code for amniotic membrane insertion in 2016. This number may have increased slightly to around 400 in 2017, but this still represents only about 1% of optometrists who practice in the United States. In 2021 amniotic membranes sales reached $3.1 billion in the US, and adoption is increasing significantly, a recent report suggests that the US market will triple by 2030.