Amniotic membrane transplantation for ocular surface reconstruction

Abstract

The ocular surface epithelia function with the tear film to provide clear vision and comfort, and to serve as the first line of defense. It is therefore important to understand how ocular surface health is maintained and how ocular surface failure occurs. Furthermore, it is timely to summarize new information concerning the mechanisms of action and the clinical uses of amniotic membrane transplantation for ocular surface reconstruction. Therefore, a review has been conducted of findings published since 1995.

When appropriately processed and preserved, amniotic membrane as a native matrix can be used as a graft to restore conjunctival surfaces following removal of lesions such as pterygium, tumor, scar, symblepharon, and conjunctivochalasis. It can also be used as a graft to restore corneal surfaces with limbal stem cell deficiency. For partial limbal deficiency, amniotic membrane transplantation alone is generally sufficient, while for total limbal deficiency limbal stem cell transplantation with or without corneal transplantation is required. When used as a graft or patch, amniotic membrane can facilitate healing of persistent corneal ulcers and recurrent corneal erosion, and reduce corneal haze following keratectomy.

Reported data indicate that amniotic membrane transplantation facilitates rapid healing with recovery of a normal epithelial phenotype in the epithelium by prolonging the life span of progenitor cells, and reduces inflammation, vascularization, and scarring in the stroma. Other potential uses await further exploration.