» Corneoscleral Surface Reconstruction
CORNEOSCLERAL SURFACE RECONSTRUCTION
Peristent epithelial defects and corneal ulcers
induced by: Chemical injuries, neurotrophic keratopathies, chronic
inflammation, partial or total LSCD., non healing ulcers by bactraila or
viral infection. Conventional approach: elimination of epithelial toxic
medications, punctal occlusion, bandage contact lens placement, tarsorraphy.
AMT is successful as compared to conservative therapy. Used as single layer
of multiple layered approach.
Proteolytic enzymes due to destructive after effects of ulcers is mediated
by release of proteolytic enzymes, which are released by microorganisms,
neutrophils or stromal keratocytes. (Amnio Cornea-GraftTM)
has an inhibitory effect on these enzymes. AM (Amnio Cornea-GraftTM)
provides healthy basement membrane and stroma, thereby providing rapid
epithelization and overall reduction of inflammation. Can be applied as
single or layered fashion.
CORNEAL PERFORATIONS AND DESCEMETOCELES
Causes are Chronic inflammation or infection.
Standard therapies include tissue adhesives, lamellar keratoplasty, bandage
contact lens or conjunctival flaps. These approaches do not address the
inflammatory state. Multilayer approach of AM (Amnio Cornea-GraftTM)
administration adopted. Supplies collagen, anti fibrotic and anti
inflammatory halts progressive tissue destruction, and promotes wound
healing and increasing the success rate of PK or LK.
TREATMENT OF SCLERA MELTS AND PERFORATIONS
Multilayer approach to treat sclera ulcerations and
micropcrforations. For larger sclera defects AM (Amnio Cornea-GraftTM)
can be combined with scleralpatch grafts.AM is placed over the sclera graft
patch grafts, basement side up and is sutured to the underlying sclerral and
surrounding conjunctival. Rapid epithilization and reduction of inflammation
at the site of ulceration.
Without use of adult stem cells. Limiting role in
treating. AMT (Amniotic Membrane Therapy) cannot be used to treat
disorders with associated total loss of limbal or conjunctival epithial stem
cells. Limbal stem cells are then required. Limitations in treating eyes
with severe exposure, aqueous tear deficiency and stromal ischemia. Such
conditions are addressed prior to the application of AMT(Amniotic
Membrane Therapy). In such patients surgical options like PK and LK may
work in synergy with AM (Amnio Cornea-GraftTM)
Dry amniotic membrane is double-packed in the sealed
pouch and terminally sterilized after packing. The membrane AM (Amnio
Cornea-GraftTM) must not be used if the pouch or packing
container is damaged or not intact. Membrane AM (Amnio Cornea-GraftTM)
must not be used if expiration date has passed.
Dry amniotic membrane (Amnio Cornea-GraftTM)
should be stored at ambient room temperature. No refrigeration or freezing