SlideShare a Scribd company logo
1 of 24
Dr Abhijit Wadekar
M.S., D.N.B, (Ophthal)
Cornea Fellow L.V.P.E.I, Hyderabad
Leela Eye Institute
Kalyan
 Surrounds the developing fetus
 Derived from fetal tissue
 Amnion is translucent structure adjacent to amniotic
fluid and provides nutrients
 Chorion is opaque membrane attached to the decidua
Histology
 Single layer of cuboidal epithelial cells
 A thick Basement Membrane
 Avascular stromal matrix , loosely attached to the
chorion
Introduction
 Innermost layer forming the fetal membrane.
 First used by Davis in 1910 in skin transplant.
 First documented ophthalmic application for
conjunctival surface reconstruction in 1940 by De
Roth.
 Sorsby et al in 1946 reported its use in acute ocular
burns.
 Kim and Tseng successfully reintroduced usage in 1995
Properties of Amniotic membrane
Facilitates migration of epithelial cells
Reinforcement of basal cell adhesion
Induction of epithelial cell differentiation and promotes goblet cell
differentiation
Anti-inflammatory action reduces scarring and vascularization
bacteriostatic properties
Lack of Immunogenicity
 Cytokines, growth factors and protease inhibitors
(IL4,6) EPG, FGF, TGF, HGF and 2- microglobulin.
 Exclusion of inflammatory cells with anti-protease
activities
 Suppression of TGF- signalling system and
myofibroblast differentiation of normal fibroblasts.
 Prolongation of life span and clonogenicity of
epithelial progenitor cells.
 Promotion of non-goblet cells epithelial
differentiation
 Promotion of goblet cells differentiation when
combined with epithelial fibroblast
Collection
 Consenting Sero negative (Hepatitis B and C virus,
Syphilis and HIV) maternal donors determined pre
surgery
 elective caesarian section
 Under sterile conditions
 An antibiotic cocktail covering most of Gram –positive
and Negative bacteria and fungi in Balanced Salt
Solution for 24 hours
 Second wash of BSS
 Amnion separated from chorion
Harvesting Amniotic membrane
Preservation
 BSS containing Ampicilin, Streptomycin and
Amphotericin B used.
 Scrapped manually to remove debris
 Amnion is clear and Transparent
 Nitrocellulose membranes of required size
 Epithelial/basement layer up.
 Preserved in solution containing Modified
Eagle’s Medium (MEM) and glycerol in 1:1 ratio
with 3.3% l-glutamine, 25 ug/ml Gentamicin, 50
units/ml penicillin, 100ug/ml ciprofloxacin and
0.5 mg/ml Amphotericin B
 Stored in 50 ML wide mouthed screw capped
irradiated transparent bottles at -80 Degrees
Indications
Used either as a ‘substrate’ to replace
damaged ocular tissue or
as a ‘Patch’ (Biological dressing) or
 Combination of both
Corneal diseases
Symptomatic Bullous keratopathy
Chemicalinjury
Limbal stem cell
deficiency (Partial
or total): combined
with stem cell graft
Persistent epithelial defects
Corneal ulceration
Conjunctival diseases
Stevens-Johnson Syndrome
Symblepharon lysis
Conjunctival surface reconstruction
Pterygium surgery
Post Trabeculectomy:bleb leakage or
revision
Conjunctival cicatrisation/scar
Limbal stem cell transplant on
Amniotic membrane
Surgical techniques
Thawed at room temperature
Rinsed three times in BSS
Gently separated from the
nitrocellulose paper
Epithelium-basement membrane side
up
Stromal side up, away from the eye.
The stromal side of the membrane is
sticky
Trimmed to the appropriate shape
10-0 nylon interrupted sutures
Intercepted 10-0 nylon sutures
A large therapeutic contact lens
Occasionally, a tarsorrhaphy
Sutures and contact lens are often
removed after 2 to 4 weeks
Post-operative topical treatment
Tissue-cultured limbal stem cells and
amniotic membrane
Disintegrates within 2 to 4 weeks
Storage medium should be light pink
Complications
Suture granuloma
Persist ant inflammation
Hematoma dehiscence
Shrinkage of the graft
Failure to achieve the intended effect
Infection
Dislodged or loose AM
Hemorrhage
Early disintegration
Thank You

More Related Content

What's hot

Amniotic membrane in ophthalmology
Amniotic membrane in ophthalmologyAmniotic membrane in ophthalmology
Amniotic membrane in ophthalmologyAmr Mounir
 
Scleral fixation technique
Scleral fixation techniqueScleral fixation technique
Scleral fixation techniquePanit Cherdchu
 
Minimally invasive Glaucoma surgery MIGS
Minimally invasive Glaucoma surgery MIGSMinimally invasive Glaucoma surgery MIGS
Minimally invasive Glaucoma surgery MIGSankita mahapatra
 
Limbal stem cell Deficiency; amniotic membrane transplantation
Limbal stem cell Deficiency; amniotic membrane transplantationLimbal stem cell Deficiency; amniotic membrane transplantation
Limbal stem cell Deficiency; amniotic membrane transplantationOm Patel
 
Yag capsulotomy
Yag capsulotomyYag capsulotomy
Yag capsulotomyRohit Rao
 
Phakic intraocular lens
Phakic intraocular lens Phakic intraocular lens
Phakic intraocular lens sreedhanya
 
Intrastromal Corneal Ring Segment (ICRSs)
Intrastromal Corneal Ring Segment (ICRSs)Intrastromal Corneal Ring Segment (ICRSs)
Intrastromal Corneal Ring Segment (ICRSs)DiyarAlzubaidy
 
Anatomy & physiology of cornea
Anatomy & physiology of corneaAnatomy & physiology of cornea
Anatomy & physiology of corneaMd. Nurul Islam
 
collagen crosslinking.pptx
collagen crosslinking.pptxcollagen crosslinking.pptx
collagen crosslinking.pptxpiyush tewari
 
Anatomy and embryology of anterior chamber angle ppt new
Anatomy and embryology of anterior chamber angle ppt newAnatomy and embryology of anterior chamber angle ppt new
Anatomy and embryology of anterior chamber angle ppt newanupama manoharan
 
Fuchs endothelial dystrophy.
Fuchs endothelial dystrophy.Fuchs endothelial dystrophy.
Fuchs endothelial dystrophy.DiyarAlzubaidy
 
IOL power calculation special situations
IOL power calculation special situations IOL power calculation special situations
IOL power calculation special situations Laxmi Eye Institute
 
SICS WOUND CONSTRUCTION _ Beginner's Guide
SICS WOUND CONSTRUCTION _ Beginner's Guide SICS WOUND CONSTRUCTION _ Beginner's Guide
SICS WOUND CONSTRUCTION _ Beginner's Guide Dr. Saurabh Shah
 
Lamellar keratoplasty
Lamellar keratoplastyLamellar keratoplasty
Lamellar keratoplastyAkshay Nayak
 
Refrective surgery ppt
Refrective surgery pptRefrective surgery ppt
Refrective surgery pptsubhadri manna
 

What's hot (20)

Amniotic membrane in ophthalmology
Amniotic membrane in ophthalmologyAmniotic membrane in ophthalmology
Amniotic membrane in ophthalmology
 
Scleral fixation technique
Scleral fixation techniqueScleral fixation technique
Scleral fixation technique
 
Tear film
 Tear film Tear film
Tear film
 
Minimally invasive Glaucoma surgery MIGS
Minimally invasive Glaucoma surgery MIGSMinimally invasive Glaucoma surgery MIGS
Minimally invasive Glaucoma surgery MIGS
 
Accommodating IOLs
Accommodating IOLsAccommodating IOLs
Accommodating IOLs
 
Limbal stem cell Deficiency; amniotic membrane transplantation
Limbal stem cell Deficiency; amniotic membrane transplantationLimbal stem cell Deficiency; amniotic membrane transplantation
Limbal stem cell Deficiency; amniotic membrane transplantation
 
Yag capsulotomy
Yag capsulotomyYag capsulotomy
Yag capsulotomy
 
Corneal transparency
Corneal transparency Corneal transparency
Corneal transparency
 
Phakic intraocular lens
Phakic intraocular lens Phakic intraocular lens
Phakic intraocular lens
 
Intrastromal Corneal Ring Segment (ICRSs)
Intrastromal Corneal Ring Segment (ICRSs)Intrastromal Corneal Ring Segment (ICRSs)
Intrastromal Corneal Ring Segment (ICRSs)
 
Anatomy & physiology of cornea
Anatomy & physiology of corneaAnatomy & physiology of cornea
Anatomy & physiology of cornea
 
collagen crosslinking.pptx
collagen crosslinking.pptxcollagen crosslinking.pptx
collagen crosslinking.pptx
 
Anatomy and embryology of anterior chamber angle ppt new
Anatomy and embryology of anterior chamber angle ppt newAnatomy and embryology of anterior chamber angle ppt new
Anatomy and embryology of anterior chamber angle ppt new
 
Femtosecond laser
Femtosecond laserFemtosecond laser
Femtosecond laser
 
Fuchs endothelial dystrophy.
Fuchs endothelial dystrophy.Fuchs endothelial dystrophy.
Fuchs endothelial dystrophy.
 
IOL power calculation special situations
IOL power calculation special situations IOL power calculation special situations
IOL power calculation special situations
 
SICS WOUND CONSTRUCTION _ Beginner's Guide
SICS WOUND CONSTRUCTION _ Beginner's Guide SICS WOUND CONSTRUCTION _ Beginner's Guide
SICS WOUND CONSTRUCTION _ Beginner's Guide
 
Macular hole
Macular holeMacular hole
Macular hole
 
Lamellar keratoplasty
Lamellar keratoplastyLamellar keratoplasty
Lamellar keratoplasty
 
Refrective surgery ppt
Refrective surgery pptRefrective surgery ppt
Refrective surgery ppt
 

Viewers also liked

Stem cells and amniotic membrane
Stem cells and amniotic membraneStem cells and amniotic membrane
Stem cells and amniotic membraneHesham Al-Inany
 
Eye banking and corneal transplantation 10.03.16,dr.k.n.jha
Eye banking and corneal transplantation 10.03.16,dr.k.n.jhaEye banking and corneal transplantation 10.03.16,dr.k.n.jha
Eye banking and corneal transplantation 10.03.16,dr.k.n.jhaophthalmgmcri
 
Amnion & Umbilical Cord (General Embryology)
Amnion & Umbilical Cord (General Embryology)Amnion & Umbilical Cord (General Embryology)
Amnion & Umbilical Cord (General Embryology)Dr. Sherif Fahmy
 
Limbal stem cell deficiency
Limbal stem cell deficiency Limbal stem cell deficiency
Limbal stem cell deficiency PAWAN JARWAL
 
Ocular surface disease
Ocular surface diseaseOcular surface disease
Ocular surface diseaseJessica Griego
 
New Technologies for Successfully Managing Ocular Surface Inflammation
New Technologies for Successfully Managing Ocular Surface InflammationNew Technologies for Successfully Managing Ocular Surface Inflammation
New Technologies for Successfully Managing Ocular Surface InflammationJessica Griego
 
Corneal edema after cataract surgery - MALEK AL KOTT
Corneal edema after cataract surgery - MALEK AL KOTTCorneal edema after cataract surgery - MALEK AL KOTT
Corneal edema after cataract surgery - MALEK AL KOTTMalek Al Kott
 
Corticosteroids in ophthalmology
Corticosteroids in ophthalmologyCorticosteroids in ophthalmology
Corticosteroids in ophthalmologyPaavan Kalra
 
Secondary glaucoma
Secondary glaucomaSecondary glaucoma
Secondary glaucomaJinijazz93
 
Pathology of eye i-2013-final
Pathology of eye i-2013-finalPathology of eye i-2013-final
Pathology of eye i-2013-finalkays3000
 
ultrasound biomicroscopy
ultrasound biomicroscopyultrasound biomicroscopy
ultrasound biomicroscopySSSIHMS-PG
 

Viewers also liked (20)

Stem cells and amniotic membrane
Stem cells and amniotic membraneStem cells and amniotic membrane
Stem cells and amniotic membrane
 
Eye banking
Eye bankingEye banking
Eye banking
 
Eye banking
Eye  bankingEye  banking
Eye banking
 
Eye banking and corneal transplantation 10.03.16,dr.k.n.jha
Eye banking and corneal transplantation 10.03.16,dr.k.n.jhaEye banking and corneal transplantation 10.03.16,dr.k.n.jha
Eye banking and corneal transplantation 10.03.16,dr.k.n.jha
 
Amnion & Umbilical Cord (General Embryology)
Amnion & Umbilical Cord (General Embryology)Amnion & Umbilical Cord (General Embryology)
Amnion & Umbilical Cord (General Embryology)
 
Surgery for Optometry
Surgery for OptometrySurgery for Optometry
Surgery for Optometry
 
Limbal stem cell deficiency
Limbal stem cell deficiency Limbal stem cell deficiency
Limbal stem cell deficiency
 
Ptedfemtosecond
PtedfemtosecondPtedfemtosecond
Ptedfemtosecond
 
Ocular surface disease
Ocular surface diseaseOcular surface disease
Ocular surface disease
 
New Technologies for Successfully Managing Ocular Surface Inflammation
New Technologies for Successfully Managing Ocular Surface InflammationNew Technologies for Successfully Managing Ocular Surface Inflammation
New Technologies for Successfully Managing Ocular Surface Inflammation
 
Corneal edema after cataract surgery - MALEK AL KOTT
Corneal edema after cataract surgery - MALEK AL KOTTCorneal edema after cataract surgery - MALEK AL KOTT
Corneal edema after cataract surgery - MALEK AL KOTT
 
Steroid induced glaucoma
Steroid induced glaucomaSteroid induced glaucoma
Steroid induced glaucoma
 
Corticosteroids in ophthalmology
Corticosteroids in ophthalmologyCorticosteroids in ophthalmology
Corticosteroids in ophthalmology
 
Secondary glaucoma
Secondary glaucomaSecondary glaucoma
Secondary glaucoma
 
Pathology of eye i-2013-final
Pathology of eye i-2013-finalPathology of eye i-2013-final
Pathology of eye i-2013-final
 
Eye banking
Eye bankingEye banking
Eye banking
 
Corneal edema
Corneal edemaCorneal edema
Corneal edema
 
ultrasound biomicroscopy
ultrasound biomicroscopyultrasound biomicroscopy
ultrasound biomicroscopy
 
Keratoconus 2016
Keratoconus 2016Keratoconus 2016
Keratoconus 2016
 
EYE DONATION
EYE DONATIONEYE DONATION
EYE DONATION
 

Similar to Amniotic Membrane Transplant

Rough draft pp of sigma xi sallies
Rough draft pp of sigma xi salliesRough draft pp of sigma xi sallies
Rough draft pp of sigma xi salliesdulkae
 
Management of chemical injuries
Management of chemical injuriesManagement of chemical injuries
Management of chemical injuriespooja_shukla
 
Laso corneal ulcer presentation
Laso   corneal ulcer presentationLaso   corneal ulcer presentation
Laso corneal ulcer presentationLutfi Abdallah
 
Acacia Honey Accelerates Corneal Wound Healing
Acacia Honey Accelerates Corneal Wound HealingAcacia Honey Accelerates Corneal Wound Healing
Acacia Honey Accelerates Corneal Wound HealingBee Healthy Farms
 
Biofilms in ent
Biofilms in entBiofilms in ent
Biofilms in entmosin009
 
Applied anatomy and physiology of cornea
Applied anatomy and physiology of corneaApplied anatomy and physiology of cornea
Applied anatomy and physiology of corneaAayush Chandan
 
Research Poster
Research PosterResearch Poster
Research PosterHuy Pham
 
Cell and Tissue Final Report
Cell and Tissue Final ReportCell and Tissue Final Report
Cell and Tissue Final ReportKelsey Henderson
 
Recurrent corneal erosions and ptk
Recurrent corneal erosions and ptkRecurrent corneal erosions and ptk
Recurrent corneal erosions and ptkHari Das
 
INFECTION AND IMMUNrrY, June 1977, P. 734-737Copyright © 197.docx
INFECTION AND IMMUNrrY, June 1977, P. 734-737Copyright © 197.docxINFECTION AND IMMUNrrY, June 1977, P. 734-737Copyright © 197.docx
INFECTION AND IMMUNrrY, June 1977, P. 734-737Copyright © 197.docxjaggernaoma
 
Skin and bone regeneration.
Skin and bone regeneration. Skin and bone regeneration.
Skin and bone regeneration. Munira Shahbuddin
 
Regenerative osseous surgery
Regenerative osseous surgeryRegenerative osseous surgery
Regenerative osseous surgeryAlbert Augustinè
 
Biofilms in chronic suppurative otitis media and cholesteatoma
Biofilms in chronic suppurative otitis media and cholesteatomaBiofilms in chronic suppurative otitis media and cholesteatoma
Biofilms in chronic suppurative otitis media and cholesteatomaMd Roohia
 
Matridex Dermal Filler presentationm to FACE Conference 2005 by Dr. Patrick T...
Matridex Dermal Filler presentationm to FACE Conference 2005 by Dr. Patrick T...Matridex Dermal Filler presentationm to FACE Conference 2005 by Dr. Patrick T...
Matridex Dermal Filler presentationm to FACE Conference 2005 by Dr. Patrick T...Dr. Patrick J. Treacy
 

Similar to Amniotic Membrane Transplant (20)

Rough draft pp of sigma xi sallies
Rough draft pp of sigma xi salliesRough draft pp of sigma xi sallies
Rough draft pp of sigma xi sallies
 
Management of chemical injuries
Management of chemical injuriesManagement of chemical injuries
Management of chemical injuries
 
Laso corneal ulcer presentation
Laso   corneal ulcer presentationLaso   corneal ulcer presentation
Laso corneal ulcer presentation
 
Physiology of Cornea
Physiology of CorneaPhysiology of Cornea
Physiology of Cornea
 
Acacia Honey Accelerates Corneal Wound Healing
Acacia Honey Accelerates Corneal Wound HealingAcacia Honey Accelerates Corneal Wound Healing
Acacia Honey Accelerates Corneal Wound Healing
 
Biofilms in ent
Biofilms in entBiofilms in ent
Biofilms in ent
 
Applied anatomy and physiology of cornea
Applied anatomy and physiology of corneaApplied anatomy and physiology of cornea
Applied anatomy and physiology of cornea
 
International Journal of Ophthalmology & Vision Research
International Journal of Ophthalmology & Vision ResearchInternational Journal of Ophthalmology & Vision Research
International Journal of Ophthalmology & Vision Research
 
Research Poster
Research PosterResearch Poster
Research Poster
 
Biomaterials-2
Biomaterials-2Biomaterials-2
Biomaterials-2
 
Cell and Tissue Final Report
Cell and Tissue Final ReportCell and Tissue Final Report
Cell and Tissue Final Report
 
Recurrent corneal erosions and ptk
Recurrent corneal erosions and ptkRecurrent corneal erosions and ptk
Recurrent corneal erosions and ptk
 
Physiology of cornea
Physiology of corneaPhysiology of cornea
Physiology of cornea
 
INFECTION AND IMMUNrrY, June 1977, P. 734-737Copyright © 197.docx
INFECTION AND IMMUNrrY, June 1977, P. 734-737Copyright © 197.docxINFECTION AND IMMUNrrY, June 1977, P. 734-737Copyright © 197.docx
INFECTION AND IMMUNrrY, June 1977, P. 734-737Copyright © 197.docx
 
Dental Soft tissue regeneration
Dental Soft tissue regeneration Dental Soft tissue regeneration
Dental Soft tissue regeneration
 
Biofilm.pptx
Biofilm.pptxBiofilm.pptx
Biofilm.pptx
 
Skin and bone regeneration.
Skin and bone regeneration. Skin and bone regeneration.
Skin and bone regeneration.
 
Regenerative osseous surgery
Regenerative osseous surgeryRegenerative osseous surgery
Regenerative osseous surgery
 
Biofilms in chronic suppurative otitis media and cholesteatoma
Biofilms in chronic suppurative otitis media and cholesteatomaBiofilms in chronic suppurative otitis media and cholesteatoma
Biofilms in chronic suppurative otitis media and cholesteatoma
 
Matridex Dermal Filler presentationm to FACE Conference 2005 by Dr. Patrick T...
Matridex Dermal Filler presentationm to FACE Conference 2005 by Dr. Patrick T...Matridex Dermal Filler presentationm to FACE Conference 2005 by Dr. Patrick T...
Matridex Dermal Filler presentationm to FACE Conference 2005 by Dr. Patrick T...
 

More from EBAI

Corneal Blindness - Eye Banking in India and Task Ahead
Corneal Blindness - Eye Banking in India and Task AheadCorneal Blindness - Eye Banking in India and Task Ahead
Corneal Blindness - Eye Banking in India and Task AheadEBAI
 
What does a cornea surgeon expect from Eye banks
What does a cornea surgeon expect from Eye banksWhat does a cornea surgeon expect from Eye banks
What does a cornea surgeon expect from Eye banksEBAI
 
Triple Corneal Transplant
Triple Corneal TransplantTriple Corneal Transplant
Triple Corneal TransplantEBAI
 
Tips for Eye Donation Counseling
Tips for Eye Donation CounselingTips for Eye Donation Counseling
Tips for Eye Donation CounselingEBAI
 
Eye Bank Specular Microscopy
Eye Bank Specular MicroscopyEye Bank Specular Microscopy
Eye Bank Specular MicroscopyEBAI
 
Slit Lamp Evaluation of Cornea
Slit Lamp Evaluation of CorneaSlit Lamp Evaluation of Cornea
Slit Lamp Evaluation of CorneaEBAI
 
Rural Eye Banking
Rural Eye BankingRural Eye Banking
Rural Eye BankingEBAI
 
Role of Eye Bank Beyond The Cornea - Stem Cells
Role of Eye Bank Beyond The Cornea - Stem CellsRole of Eye Bank Beyond The Cornea - Stem Cells
Role of Eye Bank Beyond The Cornea - Stem CellsEBAI
 
Role of Eye Bank beyond Cornea - Sclera
Role of Eye Bank beyond Cornea - ScleraRole of Eye Bank beyond Cornea - Sclera
Role of Eye Bank beyond Cornea - ScleraEBAI
 
Statistics
StatisticsStatistics
StatisticsEBAI
 
Pterygium Clinical Considerations
Pterygium Clinical ConsiderationsPterygium Clinical Considerations
Pterygium Clinical ConsiderationsEBAI
 
Eye Banks and Keratoplasty Centres Problems and Solutions
Eye Banks and Keratoplasty Centres Problems and SolutionsEye Banks and Keratoplasty Centres Problems and Solutions
Eye Banks and Keratoplasty Centres Problems and SolutionsEBAI
 
Public / NGO, Private Partnership in Eyebanking
Public / NGO, Private Partnership in EyebankingPublic / NGO, Private Partnership in Eyebanking
Public / NGO, Private Partnership in EyebankingEBAI
 
Patch Graft
Patch GraftPatch Graft
Patch GraftEBAI
 
Documentation of Donor Records
Documentation of Donor RecordsDocumentation of Donor Records
Documentation of Donor RecordsEBAI
 
Mr. m.k.krishna
Mr. m.k.krishnaMr. m.k.krishna
Mr. m.k.krishnaEBAI
 
Mooren’s Ulcer
Mooren’s UlcerMooren’s Ulcer
Mooren’s UlcerEBAI
 
Keratoprosthesis – when, which, how 2013
Keratoprosthesis – when, which, how 2013Keratoprosthesis – when, which, how 2013
Keratoprosthesis – when, which, how 2013EBAI
 
Increase Eye Collection Centers and Reduce Eye Banks
Increase Eye Collection Centers and Reduce Eye BanksIncrease Eye Collection Centers and Reduce Eye Banks
Increase Eye Collection Centers and Reduce Eye BanksEBAI
 
Eye Donation Counseling Techniques
Eye Donation Counseling TechniquesEye Donation Counseling Techniques
Eye Donation Counseling TechniquesEBAI
 

More from EBAI (20)

Corneal Blindness - Eye Banking in India and Task Ahead
Corneal Blindness - Eye Banking in India and Task AheadCorneal Blindness - Eye Banking in India and Task Ahead
Corneal Blindness - Eye Banking in India and Task Ahead
 
What does a cornea surgeon expect from Eye banks
What does a cornea surgeon expect from Eye banksWhat does a cornea surgeon expect from Eye banks
What does a cornea surgeon expect from Eye banks
 
Triple Corneal Transplant
Triple Corneal TransplantTriple Corneal Transplant
Triple Corneal Transplant
 
Tips for Eye Donation Counseling
Tips for Eye Donation CounselingTips for Eye Donation Counseling
Tips for Eye Donation Counseling
 
Eye Bank Specular Microscopy
Eye Bank Specular MicroscopyEye Bank Specular Microscopy
Eye Bank Specular Microscopy
 
Slit Lamp Evaluation of Cornea
Slit Lamp Evaluation of CorneaSlit Lamp Evaluation of Cornea
Slit Lamp Evaluation of Cornea
 
Rural Eye Banking
Rural Eye BankingRural Eye Banking
Rural Eye Banking
 
Role of Eye Bank Beyond The Cornea - Stem Cells
Role of Eye Bank Beyond The Cornea - Stem CellsRole of Eye Bank Beyond The Cornea - Stem Cells
Role of Eye Bank Beyond The Cornea - Stem Cells
 
Role of Eye Bank beyond Cornea - Sclera
Role of Eye Bank beyond Cornea - ScleraRole of Eye Bank beyond Cornea - Sclera
Role of Eye Bank beyond Cornea - Sclera
 
Statistics
StatisticsStatistics
Statistics
 
Pterygium Clinical Considerations
Pterygium Clinical ConsiderationsPterygium Clinical Considerations
Pterygium Clinical Considerations
 
Eye Banks and Keratoplasty Centres Problems and Solutions
Eye Banks and Keratoplasty Centres Problems and SolutionsEye Banks and Keratoplasty Centres Problems and Solutions
Eye Banks and Keratoplasty Centres Problems and Solutions
 
Public / NGO, Private Partnership in Eyebanking
Public / NGO, Private Partnership in EyebankingPublic / NGO, Private Partnership in Eyebanking
Public / NGO, Private Partnership in Eyebanking
 
Patch Graft
Patch GraftPatch Graft
Patch Graft
 
Documentation of Donor Records
Documentation of Donor RecordsDocumentation of Donor Records
Documentation of Donor Records
 
Mr. m.k.krishna
Mr. m.k.krishnaMr. m.k.krishna
Mr. m.k.krishna
 
Mooren’s Ulcer
Mooren’s UlcerMooren’s Ulcer
Mooren’s Ulcer
 
Keratoprosthesis – when, which, how 2013
Keratoprosthesis – when, which, how 2013Keratoprosthesis – when, which, how 2013
Keratoprosthesis – when, which, how 2013
 
Increase Eye Collection Centers and Reduce Eye Banks
Increase Eye Collection Centers and Reduce Eye BanksIncrease Eye Collection Centers and Reduce Eye Banks
Increase Eye Collection Centers and Reduce Eye Banks
 
Eye Donation Counseling Techniques
Eye Donation Counseling TechniquesEye Donation Counseling Techniques
Eye Donation Counseling Techniques
 

Recently uploaded

How to buy 5cladba precursor raw 5cl-adb-a raw material
How to buy 5cladba precursor raw 5cl-adb-a raw materialHow to buy 5cladba precursor raw 5cl-adb-a raw material
How to buy 5cladba precursor raw 5cl-adb-a raw materialSherrylee83
 
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptxGross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptxDr. Rabia Inam Gandapore
 
Top 15 Sexiest Pakistani Pornstars with Images & Videos
Top 15 Sexiest Pakistani Pornstars with Images & VideosTop 15 Sexiest Pakistani Pornstars with Images & Videos
Top 15 Sexiest Pakistani Pornstars with Images & Videoslocantocallgirl01
 
parliaments-for-health-security_RecordOfAchievement.pdf
parliaments-for-health-security_RecordOfAchievement.pdfparliaments-for-health-security_RecordOfAchievement.pdf
parliaments-for-health-security_RecordOfAchievement.pdfDr. Nasir Mustafa
 
Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024locantocallgirl01
 
spinal cord disorders and paraplegia .
spinal cord disorders  and  paraplegia .spinal cord disorders  and  paraplegia .
spinal cord disorders and paraplegia .Mohamed Rizk Khodair
 
Treatment Choices for Slip Disc at Gokuldas Hospital
Treatment Choices for Slip Disc at Gokuldas HospitalTreatment Choices for Slip Disc at Gokuldas Hospital
Treatment Choices for Slip Disc at Gokuldas HospitalGokuldas Hospital
 
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptxNegative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptxAdhithya Mullath Ullas
 
Unit 4 Pharmaceutical Organic Chemisty 3 Quinoline
Unit 4 Pharmaceutical Organic Chemisty 3 QuinolineUnit 4 Pharmaceutical Organic Chemisty 3 Quinoline
Unit 4 Pharmaceutical Organic Chemisty 3 QuinolineAarishRathnam1
 
Forensic medicine MCQ for early learners
Forensic medicine MCQ for early learnersForensic medicine MCQ for early learners
Forensic medicine MCQ for early learnersAlaguPandi5
 
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...rightmanforbloodline
 
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...rightmanforbloodline
 
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose AcademicsHistology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose AcademicsMedicoseAcademics
 
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose AcademicsConnective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose AcademicsMedicoseAcademics
 
BURNS (CLASSIFICATION & MANAGEMENTS).pdf
BURNS (CLASSIFICATION & MANAGEMENTS).pdfBURNS (CLASSIFICATION & MANAGEMENTS).pdf
BURNS (CLASSIFICATION & MANAGEMENTS).pdfDolisha Warbi
 
Overview on the Automatic pill identifier
Overview on the Automatic pill identifierOverview on the Automatic pill identifier
Overview on the Automatic pill identifierNidhi Joshi
 
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...rightmanforbloodline
 
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan 081901222272 Obat Penggugur Kandu...
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan  081901222272 Obat Penggugur Kandu...Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan  081901222272 Obat Penggugur Kandu...
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan 081901222272 Obat Penggugur Kandu...Halo Docter
 
Cytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose Academics
Cytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose AcademicsCytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose Academics
Cytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose AcademicsMedicoseAcademics
 
Benefits of Chanting Hanuman Chalisa .pdf
Benefits of Chanting Hanuman Chalisa .pdfBenefits of Chanting Hanuman Chalisa .pdf
Benefits of Chanting Hanuman Chalisa .pdfLearnyoga
 

Recently uploaded (20)

How to buy 5cladba precursor raw 5cl-adb-a raw material
How to buy 5cladba precursor raw 5cl-adb-a raw materialHow to buy 5cladba precursor raw 5cl-adb-a raw material
How to buy 5cladba precursor raw 5cl-adb-a raw material
 
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptxGross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
 
Top 15 Sexiest Pakistani Pornstars with Images & Videos
Top 15 Sexiest Pakistani Pornstars with Images & VideosTop 15 Sexiest Pakistani Pornstars with Images & Videos
Top 15 Sexiest Pakistani Pornstars with Images & Videos
 
parliaments-for-health-security_RecordOfAchievement.pdf
parliaments-for-health-security_RecordOfAchievement.pdfparliaments-for-health-security_RecordOfAchievement.pdf
parliaments-for-health-security_RecordOfAchievement.pdf
 
Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024
 
spinal cord disorders and paraplegia .
spinal cord disorders  and  paraplegia .spinal cord disorders  and  paraplegia .
spinal cord disorders and paraplegia .
 
Treatment Choices for Slip Disc at Gokuldas Hospital
Treatment Choices for Slip Disc at Gokuldas HospitalTreatment Choices for Slip Disc at Gokuldas Hospital
Treatment Choices for Slip Disc at Gokuldas Hospital
 
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptxNegative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
 
Unit 4 Pharmaceutical Organic Chemisty 3 Quinoline
Unit 4 Pharmaceutical Organic Chemisty 3 QuinolineUnit 4 Pharmaceutical Organic Chemisty 3 Quinoline
Unit 4 Pharmaceutical Organic Chemisty 3 Quinoline
 
Forensic medicine MCQ for early learners
Forensic medicine MCQ for early learnersForensic medicine MCQ for early learners
Forensic medicine MCQ for early learners
 
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
 
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
TEST BANK For Guyton and Hall Textbook of Medical Physiology, 14th Edition by...
 
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose AcademicsHistology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
 
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose AcademicsConnective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
 
BURNS (CLASSIFICATION & MANAGEMENTS).pdf
BURNS (CLASSIFICATION & MANAGEMENTS).pdfBURNS (CLASSIFICATION & MANAGEMENTS).pdf
BURNS (CLASSIFICATION & MANAGEMENTS).pdf
 
Overview on the Automatic pill identifier
Overview on the Automatic pill identifierOverview on the Automatic pill identifier
Overview on the Automatic pill identifier
 
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
 
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan 081901222272 Obat Penggugur Kandu...
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan  081901222272 Obat Penggugur Kandu...Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan  081901222272 Obat Penggugur Kandu...
Obat Aborsi Ampuh Usia 1,2,3,4,5,6,7 Bulan 081901222272 Obat Penggugur Kandu...
 
Cytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose Academics
Cytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose AcademicsCytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose Academics
Cytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose Academics
 
Benefits of Chanting Hanuman Chalisa .pdf
Benefits of Chanting Hanuman Chalisa .pdfBenefits of Chanting Hanuman Chalisa .pdf
Benefits of Chanting Hanuman Chalisa .pdf
 

Amniotic Membrane Transplant

  • 1. Dr Abhijit Wadekar M.S., D.N.B, (Ophthal) Cornea Fellow L.V.P.E.I, Hyderabad Leela Eye Institute Kalyan
  • 2.  Surrounds the developing fetus  Derived from fetal tissue  Amnion is translucent structure adjacent to amniotic fluid and provides nutrients  Chorion is opaque membrane attached to the decidua
  • 3. Histology  Single layer of cuboidal epithelial cells  A thick Basement Membrane  Avascular stromal matrix , loosely attached to the chorion
  • 4. Introduction  Innermost layer forming the fetal membrane.  First used by Davis in 1910 in skin transplant.  First documented ophthalmic application for conjunctival surface reconstruction in 1940 by De Roth.  Sorsby et al in 1946 reported its use in acute ocular burns.  Kim and Tseng successfully reintroduced usage in 1995
  • 5. Properties of Amniotic membrane Facilitates migration of epithelial cells Reinforcement of basal cell adhesion Induction of epithelial cell differentiation and promotes goblet cell differentiation Anti-inflammatory action reduces scarring and vascularization bacteriostatic properties Lack of Immunogenicity
  • 6.  Cytokines, growth factors and protease inhibitors (IL4,6) EPG, FGF, TGF, HGF and 2- microglobulin.  Exclusion of inflammatory cells with anti-protease activities  Suppression of TGF- signalling system and myofibroblast differentiation of normal fibroblasts.  Prolongation of life span and clonogenicity of epithelial progenitor cells.  Promotion of non-goblet cells epithelial differentiation  Promotion of goblet cells differentiation when combined with epithelial fibroblast
  • 7. Collection  Consenting Sero negative (Hepatitis B and C virus, Syphilis and HIV) maternal donors determined pre surgery  elective caesarian section  Under sterile conditions  An antibiotic cocktail covering most of Gram –positive and Negative bacteria and fungi in Balanced Salt Solution for 24 hours  Second wash of BSS  Amnion separated from chorion
  • 9. Preservation  BSS containing Ampicilin, Streptomycin and Amphotericin B used.  Scrapped manually to remove debris  Amnion is clear and Transparent  Nitrocellulose membranes of required size  Epithelial/basement layer up.
  • 10.  Preserved in solution containing Modified Eagle’s Medium (MEM) and glycerol in 1:1 ratio with 3.3% l-glutamine, 25 ug/ml Gentamicin, 50 units/ml penicillin, 100ug/ml ciprofloxacin and 0.5 mg/ml Amphotericin B  Stored in 50 ML wide mouthed screw capped irradiated transparent bottles at -80 Degrees
  • 11. Indications Used either as a ‘substrate’ to replace damaged ocular tissue or as a ‘Patch’ (Biological dressing) or  Combination of both
  • 13. Chemicalinjury Limbal stem cell deficiency (Partial or total): combined with stem cell graft
  • 15. Conjunctival diseases Stevens-Johnson Syndrome Symblepharon lysis Conjunctival surface reconstruction Pterygium surgery Post Trabeculectomy:bleb leakage or revision
  • 17. Limbal stem cell transplant on Amniotic membrane
  • 18. Surgical techniques Thawed at room temperature Rinsed three times in BSS Gently separated from the nitrocellulose paper Epithelium-basement membrane side up
  • 19. Stromal side up, away from the eye. The stromal side of the membrane is sticky Trimmed to the appropriate shape 10-0 nylon interrupted sutures Intercepted 10-0 nylon sutures
  • 20. A large therapeutic contact lens Occasionally, a tarsorrhaphy Sutures and contact lens are often removed after 2 to 4 weeks Post-operative topical treatment
  • 21.
  • 22. Tissue-cultured limbal stem cells and amniotic membrane Disintegrates within 2 to 4 weeks Storage medium should be light pink
  • 23. Complications Suture granuloma Persist ant inflammation Hematoma dehiscence Shrinkage of the graft Failure to achieve the intended effect Infection Dislodged or loose AM Hemorrhage Early disintegration