What is amniotic membrane
Amniotic membrane is a unique membrane that is a part of the placenta, the region where a fetus develops and grown in a mother’s womb. Amniotic membrane is the innermost part of the placenta, which is closest to the baby during its development. This membrane acts to protect the baby from any harm in the womb. The amniotic membrane has qualities that make it suitable for healing wounds, and regenerating tissue in delicate parts of the body like the eyes. The amniotic membrane is obtained in a sterile environment from the placenta of mothers undergoing elective C-section under their consent. Contributing mothers are tested for all kinds of infections.
Characteristics of Amniotic Membrane
Amniotic membrane consists of several types of collagen, essential growth factors and special proteins like laminins, fibronectin, and proteoglycans. The structure of the amniotic membrane resembles that of the delicate parts of the eye like the cornea and the conjunctiva.The following are some of the characteristics due to which the amniotic membrane provides an ideal method of treatment in case of various diseases of the eye:
- Mechanical properties - The amniotic membrane can work like a biological bandage that protects the epithelium from external agents. It reduces pain and discomfort in the process.
- Collagen composition - The collagen composition of amniotic membrane is quite similar to that of the cornea and the conjunctiva. This provides an ideal environment for the growth of epithelial cells. This is achieved because the composition promotes epithelial cell migration, basal epithelial cell adhesion, and cell differentiation. It also prevents apoptosis. Thus, AM can be used in case of epithelial defects of the cornea that are persistent.
Types of amniotic membrane
For medical use, the following two types of amniotic membrane are available:
- Cryopreserved amniotic membrane, example - Prokera - stored frozen by slow freezing; must come to room temperature before use
- Dehydrated amniotic membrane, example - AmbioDisk - stored using a low-temperature vacuum; must be rehydrated before use
What is Prokera?
Prokera is a device that uses a cryopreserved amniotic membrane tissue packaged between two clear, flexible, polycarbonate rings.
Uses of Prokera
Prokera can be used to treat eye conditions like corneal scars, corneal ulcers, recurring corneal erosions, chemical burns, keratitis, cases of severe dry eye, Steven-Johnson Syndrome, and some other eye conditions .
Types of Prokera
Prokera is available in three different thicknesses. - Prokera Slim, Prokera, Prokera Plus. Your optometrist will suggest a type based on the condition of your eye you want to treat and its severity.
How it is used
Once Prokera has been brought to the room temperature following the recommended methods, it gets a saline rinse to wash off the anti-infective glycerol medium in which it is packaged. Prokera can be applied in one go without the need of sutures. While you look down, the doctor will pull your upper eyelid and slide the device down your lower lid and will make sure that it is correctly placed over the cornea. You will be required to keep it in for five to seven days (FDA-approved maximum - 8 days) depending on the severity of condition. The polycarbonate ring/device is removed after the AM has dissolved or if the condition has fully healed.
Is Prokera safe and effective
Prokera is safe and FDA-approved. The amniotic membrane used in it undergoes rigorous quality tests. Prokera has been seen to be effective in healing the surface of the eye. You need to get it properly evaluated by a specialist to ensure if it is a right solution for your condition. Allergic reactions and rejections have not been reported with the device.