Amniotic membranes have been used since the 1990’s to promote corneal healing in severely damaged eyes. They are made from the amniotic membranes that protect the unborn baby in the womb. In the past they have been sutured or glued in place. In recent times, there is a device that is like a big contact lens called Prokera. It consists of a ring and a membrane of amniotic tissue. This is place on a severely damaged cornea and remains in place for a number of days. The membrane would typically dissolve in 5-7 days. It can be used for moderate to severe dry eye as well as a range of significant corneal problems. The advantage of this device is that can can be inserted in the doctor’s office
It has three effects, firstly it is a powerful anti-inflammatory like steroids only without the side effects. Secondly, the amniotic tissue has a profound regenerative effect on the cornea due to the abundance of nerve growth and other healing factors. Thirdly the coverage of the cornea provides a barrier to dehydration. Over a few days the health of the cornea rapidly improves and the pain and discomfort subsides. Some refer to this as being like a biological bandage for a damaged cornea.
This treatment doesn’t do anything for the underlying factors that cause the ocular surface issue but can give the cornea a chance to heal and offers a prolonged period of remission. Some find it a little uncomfortable and it blurs the vision while in place. It is also fairly expensive at around $1000 to $2000.
This device is not currently available in Australia but is available in the USA. It has to be cryopreserved which would present handling difficulties. In Australia, biological materials such as this are carefully regulated by the Therapeutic Goods Administration (TGA)
There is another version of this device called AmbioDisk this is a dry wafer thin processed disk of tissue that can be stored at room temperature. It is placed on the inside of a contact lens which holds it against the surface of the eye for a few days. It dissolves in 2-3 days. It has similar properties to the Prokera device. This is not currently available in Australia. Given it’s ease of handling there is more possibility of obtaining it.
A third way of delivering amniotic healing to the eye is through amniotic extract drops. A US company called Regener-Eyes has recently released a product. It is usually dosed once per day and can be used over many months to control inflammation and promote healing. It is not widely available in the USA and is not available in Australia.
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