Amniotic membranes have become a popular choice among practitioners for corneal related issues. These stem cell contact lenses can be used for dry eye, corneal abrasions, recurrent corneal erosions, corneal ulcers, filamentary keratitis, corneal ulcers, chemical burns, and more! I have found a great place for them in my practice. For mild superficial keratitis and minor abrasions, I will still reach for my classic bandage contact lens, but when bigger and more serious problems arise, I reach for the amniotic membranes. I have personally seen corneal ulcers heal with less pain and less scar tissue compared to a bandage contact lens. I think it is a fantastic option for patients with chemical burns.
The mechanism of action of amniotic membranes is poorly understood, but some research shows that growth factors and heavy chain hyaluronic acid may play a role. Whatever the mechanism is, it works very well for many corneal conditions.
Amniotic membranes can also decrease inflammation on the ocular surface, which makes it a good choice for patients with an acute corneal condition or even a chronic condition like dry eye.
Inserting and removing amniotic membranes is easy. Whether you opt to use the dehydrated type or cryo-preserved, both application techniques are easy for most practitioners to master quickly. If you are not comfortable, simply reach out to a representative to come show you! I live in a very rural area, and the representative drove over three hours to visit me to help with some of my first cases.
So, when do you reach for an amniotic membrane versus a bandage lens? In my experience, it depends on the condition being treated, along with the patient preference. Amniotic membranes can be costly, but I feel as practitioners, it is our duty to present the patient with all the best options and let them decide. I’ve had patients without insurance opt for the amniotic membrane to treat their eye due to the severity or risk of their condition. I am curious to know how many ODs are embracing this technology? What conditions do you find amniotic membranes to help? How do patients respond? What are you noticing objectively and subjectively?