65778 Placement of amniotic membrane on the ocular surface; without sutures

Name of the Procedure:

Placement of Amniotic Membrane on the Ocular Surface; Without Sutures
Common Names: Amniotic membrane graft, Sutureless amniotic membrane transplantation
Technical Terms: Amniotic membrane placement, Sutureless AMT

Summary

This procedure involves placing a specially prepared tissue (amniotic membrane) on the surface of the eye to promote healing and protect the cornea. It’s done without the use of sutures, making it less invasive.

Purpose

Medical Condition: It treats various ocular surface disorders such as persistent epithelial defects, chemical burns, corneal ulcers, and dry eye syndrome.
Goals/Outcomes: The goal is to reduce inflammation, promote healing of the eye surface, and restore normal vision.

Indications

• Persistent corneal defects or ulcers
• Chemical or thermal burns to the eye surface
• Severe dry eye syndrome unresponsive to other treatments
• Pterygium surgery or other ocular surgeries requiring surface healing
• Corneal diseases like Herpes Simplex Keratitis

Preparation

• No fasting is typically required.
• Patients may need to stop certain medications as advised by their doctor.
• Preliminary eye examination and tests, such as visual acuity and tear film assessment, may be conducted.

Procedure Description

1. The eye is anesthetized using topical anesthesia drops.
2. A specially processed amniotic membrane is prepared and placed over the affected area of the eye.
3. The membrane is secured in place typically using a bandage contact lens instead of sutures.
4. The patient is monitored for a short period following the procedure.

Tools/Equipment: Amniotic membrane, sterile ophthalmic tools, bandage contact lens, anesthesia drops.
Anesthesia: Topical anesthesia (eye drops).

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is usually performed in an outpatient clinic or an ophthalmology office.

Personnel

• Ophthalmologist or Corneal Specialist
• Ophthalmic Nurse or Assistant

Risks and Complications

Common Risks: Temporary discomfort, irritation, or foreign body sensation in the eye. Rare Risks: Infection, membrane dislocation, unsuccessful healing requiring additional procedures. Management: Follow-up visits to monitor healing, prescribed antibiotic or anti-inflammatory drops.

Benefits

• Promotes faster and more effective healing of the ocular surface.
• Reduces pain and discomfort associated with ocular surface disorders.
• Can improve vision impacted by corneal surface defects.
• Non-invasive compared to traditional sutured methods.

Recovery

• Patients may need to use prescribed eye drops to prevent infection and promote healing.
• Follow-up appointments are necessary to monitor the progress.
• Recovery time can range from a few days to a few weeks, depending on the underlying condition.
• Temporary restrictions might include avoiding rubbing the eyes, swimming, and strenuous activities.

Alternatives

• Sutured amniotic membrane transplantation
• Topical medications (antibiotics, steroids)
• Autologous serum eye drops
• Surgical options like corneal transplants in severe cases

Pros and Cons: Non-sutured AMT usually involves less discomfort and a quicker recovery compared to sutured methods. However, sutured methods might be necessary for more severe cases.

Patient Experience

During the procedure, patients typically feel minimal pain due to the topical anesthesia. Post-procedure, they might experience mild discomfort, akin to having a contact lens in the eye. Pain management includes using prescribed eye drops, and most patients find relief and improvement within days.