Human amniotic membrane transplantation: Different modalities of its use in ophthalmology

Figure 1 Line diagram showing layers of cryopreserved human amniotic membrane, oriented with the stromal side in contact with the nitrocellulose filter paper and epithelial side facing up.

Figure 2 (A) Amniotic membrane used as an inlay graft (B) line diagram showing amniotic membrane (solid orange lines) used as an Inlay graft for a non-healing epithelial defect (green). The membrane is trimmed to fit the size of the underlying defect and sutured to the cornea using interrupted 10-0 nylon monofilament sutures.

Figure 3 Amniotic membrane used as an overlay patch. A: Clinical photograph; B: Line diagram. The amniotic membrane is trimmed to cover the whole of the corneal surface and fixed by 10-0 nylon monofilamemt sutures at the corneal periphery parallel to the limbus.

Figure 4 Single layer inlay covered by a larger “patch” or “onlay” (A), multi-layer inlay ( amniotic membrane folded upon itself in form of a blanket fold- black arrow) covered by a larger “patch” which is fixed to underlying episclera by a purse string suture in a case of deep, non-resolving peripheral ulcerative keratitis (B).

Figure 5 Amniotic membrane used to cover bare sclera after excision of primary pterygium. A-D: Serial photographs showing appearance of amniotic membrane graft. At end of 3 mo excellent integration and cosmetic appearance was achieved.