Processed Amniotic Membrane Allografts. Amniotic Membrane Allografts.

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Transcript of Processed Amniotic Membrane Allografts. Amniotic Membrane Allografts.

Processed Amniotic Processed Amniotic Membrane Membrane AllograftsAllografts

Amniotic Membrane AllograftsAmniotic Membrane Allografts

What Is Human Amniotic Membrane?What Is Human Amniotic Membrane?

• A unique, avascular membrane separating the mother from the fetus.

• Provides an incubating environment promoting cellular differentiation.

• Provides an immunological barrier to prevent “foreign body” rejection.

Anatomical Profile: AMAnatomical Profile: AM

Anatomy of the Ocular SurfaceAnatomy of the Ocular Surface

(1) Conjunctival Epithelium

(2) Corneal Epithelium

(6) Limbus – Stem Cells

History of AM in OphthalmologyHistory of AM in Ophthalmology

• De Rotth. conjunctival defects (1940).• Lavery. lime burn of conjunctiva and cornea (1946).• Sorsby et al. caustic soda burns (1947).• ALLOTRANSPLANTAT [late 80’s USSR->Venezuela, DR]

• Batlle and Perdomo. Conjunctival substitute with placental allotransplant. Scientific Poster 25. American Academy of Ophthalmology meeting. Chicago, IL USA. October 1993.

• Kim and Tseng. Transplantation of preserved human amniotic membrane for surface reconstruction in severely damaged rabbit corneas. Cornea 14:473-84, 1995. [

Surgical Indications: AMSurgical Indications: AM

• Pterygium Excision• Corneal Ulcerations/Perforations• Chemical/Thermal Burns• Bullous Keratopathy• Ocular Dermoids/Tumors• Fornix Reconstruction/Symblepharon• Stem Cell Transplants

PterygiumPterygium

• A mutated growth on the surface of the eye

• Requires surgical excision and placement of graft

Corneal Ulcerations/perforationsCorneal Ulcerations/perforations

• A break or defect in corneal epithelium

• Often secondary to other systemic diseases.

Chemical/thermal BurnsChemical/thermal Burns

• Chemical burns often caused by alkali

• Potentially devastating trauma to surface of the eye

• Limbal graft possibly indicated

Bullous KeratopathyBullous Keratopathy

• Edema of the corneal endothelium

• Very common and usually affects individuals over 50 years of age.

Dermoid/tumor RemovalDermoid/tumor Removal

• Benign congenital tumors containing foreign tissue

• Commonly found at the limbus

Fornix ReconstructionFornix Reconstruction

• Fibrous tract that connects bulbar conj to conj of eyelid

• Secondary to other acquired or traumatic conditions

• Required reconstruction of ocular surface and eyelids

Surgical Techniques: Amt/pterygiumSurgical Techniques: Amt/pterygium

AmbiodryAmbiodry22 Overview Overview

• Tested & Safe• Dehydrated• Terminally Sterilized• Strict, quality-

controlled protocols• Device-like quality

AmbioDry: Safe & ViableAmbioDry: Safe & Viable

•Intact epithelial cell layer

•Intact dense connective, basement membrane

•Presence of loose fibroblast network

AmbioDry: Logistical FeaturesAmbioDry: Logistical Features

• Storage: Room-temp• No freezer required• No dry ice shipments• Simple prep: No soaks or rinses• IOP Customer Service: 24 Hrs/7 Days

AmbioDry: Surgical AdvantagesAmbioDry: Surgical Advantages• Substrate-free• Dry-state handling & trimming• Visual orientation identification• No tears or buttonholes• Device-like tissue quality

AmbioDry ConfigurationsAmbioDry Configurations

• 1 x 2 cm

• 2 x 3 cm

• 4 x 4 cm

Reimbursement Codes

Supply code: V2790

CPT code: 65780 ocular surface reconstruction; Amniotic membrane transplantation

AmbioDry & TisseelAmbioDry & Tisseel

The sutureless approach to eye surgery.

Fibrin (biological) adhesive

Eliminates sutures

Reduces surgical time

Improved patient care

Better healing

AmbioDry & Tisseel VideoAmbioDry & Tisseel Video