Abstract

The use of amniotic membrane (AM) is a widespread clinical practice for eye surgeries and the treatment of an increasing number of ocular surface pathologies. Here we describe the AM collection methods and donor selection criteria adopted by our tissue bank to distribute 5349 amniotic membrane patches over the last 12 years for the treatment of several ocular pathologies. Specific quality control measures are described and the long term results attained using the reported procedure are presented. A case of AM utilized to treat severe ocular ulceration is also described as an example of AM transplantation. Collective data for the total amniotic membrane patches deployed to treat various ocular diseases are discussed and success rates for AM transplantations are reported. An extensive follow-up is illustrated. The results suggest that the procedures and protocols used by the Treviso Tissue Bank Foundation and Veneto Eye Bank Foundation for collection, preservation, distribution and follow-up are of an optimal standard. Accordingly, the authors conclude that the safety and efficiency of the proposed procedure for the therapeutic use of AM to treat various ocular pathologies are reproducible, with additional evidence favoring the use of AM as an alternative to conventional medical treatment for certain ocular conditions.

Highlights

  • The amniotic membrane (AM) is the inner layer of the fetal membranes and is comprised of three distinct layers; epithelium, basement membrane and stroma, the innermost layer that further consists of an inner compact layer, middle fibroblast layer and an outermost spongy layer

  • During the 12-year follow-up, 5604 amniotic membranes were isolated from 215 placentas, of which 5192 membrane patches were used for transplantation, 342 were discarded and 70 were selected for research

  • None of the distributed membranes were positive for contamination after thawing, demonstrating the reliability of the microbiological controls performed during tissue collection

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Summary

Introduction

The amniotic membrane (AM) is the inner layer of the fetal membranes and is comprised of three distinct layers; epithelium, basement membrane and stroma, the innermost layer that further consists of an inner compact layer, middle fibroblast layer and an outermost spongy layer. AM can be used as a temporary graft and functions as a basement membrane substitute in the eye; the presence of several growth factors in the AM tissue, together with its function as a structural support providing a basal membrane for new cell growth, are believed to be the main mechanisms by which the procedure achieves its therapeutic effects. Another important property of AM is its ability to inhibit vascularization. Storage for an indefinite period has been suggested

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