Published online Jun 24, 2014. doi: 10.5500/wjt.v4.i2.111
Revised: March 1, 2014
Accepted: May 8, 2014
Published online: June 24, 2014
The amniotic membrane (AM) is the inner layer of the fetal membranes and consist of 3 different layers: the epithelium, basement membrane and stroma which further consists of three contiguous but distinct layers: the inner compact layer, middle fibroblast layer and the outermost spongy layer. The AM has been shown to have anti-inflammatory, anti-fibrotic, anti-angiogenic as well as anti-microbial properties. Also because of its transparent structure, lack of immunogenicity and the ability to provide an excellent substrate for growth, migration and adhesion of epithelial corneal and conjunctival cells, it is being used increasingly for ocular surface reconstruction in a variety of ocular pathologies including corneal disorders associated with limbal stem cell deficiency, surgeries for conjunctival reconstruction, as a carrier for ex vivo expansion of limbal epithelial cells, glaucoma surgeries and sceral melts and perforations. However indiscriminate use of human AM needs to be discouraged as complications though infrequent can occur. These include risk of transmission of bacterial, viral or fungal infections to the recipient if the donors are not adequately screened for communicable diseases, if the membrane is not processed under sterile conditions or if storage is improper. Optimal outcomes can be achieved only with meticulous case selection. This review explores the ever expanding ophthalmological indications for the use of human AM.
Core tip: Amniotic membrane transplantation is a very useful armamentarium in the hands of the ophthalmic surgeons for treating a variety of ocular surface disorders. Because of its transparent structure, anti- inflammatory, anti-fibrotic and anti-angiogenic properties and ability to provide a substrate for growth of corneal and conjunctival epithelial cells, it forms an ideal material for ocular surface reconstruction.