65779 Placement of amniotic membrane on the ocular surface; single layer, sutured

Name of the Procedure:

Placement of Amniotic Membrane on the Ocular Surface; Single Layer, Sutured
Common names: Amniotic membrane transplantation, AMT

Summary

In this procedure, a layer of amniotic membrane (a part of the fetal membrane) is surgically placed and sutured onto the surface of the eye. This acts as a temporary biological bandage to promote healing and reduce inflammation.

Purpose

The procedure addresses ocular surface disorders such as corneal ulcers, chemical burns, or persistent epithelial defects. The goal is to promote healing, reduce scarring, and alleviate pain and inflammation, ultimately leading to restored and improved ocular surface health.

Indications

• Non-healing or persistent corneal ulcers
• Chemical or thermal burns to the eye
• Stevens-Johnson syndrome
• Pterygium surgery adjunct
• Severe dry eye syndrome
• Herpes simplex keratitis

Preparation

• Disclose all medications to your doctor; some may need to be stopped.
• Fasting may be required if sedation or anesthesia is used.
• Pre-procedure eye examinations and imaging tests may be conducted.
• Arrange for transportation, as your vision may be impaired post-procedure.

Procedure Description

1. Anesthetic drops are applied to numb the eye.
2. The eye is cleaned and sterilized.
3. A single layer of amniotic membrane is prepared and positioned over the affected area of the eye.
4. The membrane is then sutured in place with tiny, delicate stitches.
5. Antibiotic drops are applied to prevent infection.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is usually performed in an outpatient clinic, a specialized eye care center, or a hospital.

Personnel

• Ophthalmic surgeon
• Ophthalmic nurse
• Anesthesiologist (if sedation is used)

Risks and Complications

• Infection
• Displacement or dislodgment of the membrane
• Intraocular pressure increase
• Allergic reactions
• Visual disturbances
• Rarely, suture-related complications

Benefits

• Rapid healing of the ocular surface
• Reduced inflammation and scarring
• Pain relief
• Improved vision and ocular comfort Benefits are often noticeable within days to weeks after the procedure.

Recovery

• Use prescribed eye drops to prevent infection and reduce inflammation.
• Avoid rubbing or touching the eye.
• Attend follow-up appointments for monitoring and suture removal.
• Recovery time can vary from a few days to several weeks, with specific activity restrictions depending on the individual's condition.

Alternatives

• Conservative medical management (e.g., eye drops, ointments)
• Other surgical interventions (e.g., conjunctival flap surgery)
• Autologous serum eye drops Pros and cons:
• Medical management may be less invasive but slower to yield results.
• Surgical alternatives may vary in efficacy and risk profiles but might be more suitable for different conditions.

Patient Experience

• During the procedure: Patients may feel minimal discomfort due to anesthetic drops. Sedation may be used if needed.
• After the procedure: Some discomfort, blurry vision, and a sandy or gritty sensation in the eye. Pain can usually be managed with over-the-counter pain relievers and prescribed medications. Follow-up care is crucial for successful recovery.