This patient-education article is written by the cornea service at Suraj Eye Institute, Nagpur.

What is Amniotic Membrane Transplantation?

The amniotic membrane is the innermost layer of the placenta. It is rich in growth factors, anti-inflammatory cytokines and anti-scarring proteins, and it provides a smooth basement membrane on which corneal epithelial cells can grow. When applied to a damaged ocular surface it reduces inflammation, accelerates epithelial healing and minimises scarring. The tissue is donated, screened, processed and either cryopreserved or freeze-dried before use.

Amniotic Membrane — Graft vs Patch

Amniotic Membrane — Two Techniques

AMT GRAFT (filling a defect)

Single or multi-layered tissue incorporates into the stroma Sutured (or glued) into the defect

AMT PATCH (biological bandage)

Single layer overlies the cornea like a biological bandage Dissolves over 2–3 weeks; not incorporated into the cornea

Figure 1. Two ways to use amniotic membrane. Graft: one or more layers of membrane are sutured (or glued) into a corneal or conjunctival defect and become incorporated into the healing tissue. Patch (also called overlay): a single layer is secured over the entire ocular surface as a biological bandage; it dissolves over 2–3 weeks and does not become part of the cornea. Many eyes need a combination of both — graft tissue in the defect plus a patch overlying the whole surface.

How AMT Helps

  • Reduces inflammation through anti-inflammatory cytokines in the membrane
  • Suppresses scarring through anti-fibrotic factors
  • Promotes epithelial healing by providing a basement membrane scaffold
  • Provides pain relief by covering exposed corneal nerve endings

Indications

  • Acute and chronic chemical eye injury — applied within the first week to reduce inflammation and limbal damage
  • Non-healing infectious ulcers, including bacterial, fungal and viral keratitis with persistent epithelial defects or impending perforation
  • Severe VKC shield ulcers that have not healed with medical treatment
  • Neurotrophic keratopathy — chronic non-healing defects in eyes with reduced corneal sensation
  • Recurrent pterygium surgery as an adjunct to conjunctival autograft
  • Ocular surface reconstruction in stem-cell deficiency and after symblepharon release

What to Expect

AMT is performed in the operating theatre under topical or local anaesthesia. The unhealthy epithelium is gently debrided, the membrane is fashioned to the defect and sutured or glued in place. A bandage contact lens is usually placed at the end of the procedure. Patients are reviewed within 24–48 hours, then at 1 and 2 weeks. The membrane patch typically dissolves over 2–3 weeks; graft tissue is gradually integrated.

✔ Amniotic Membrane Surgery at Suraj Eye Institute

We use amniotic membrane grafts and patches for non-healing infectious ulcers, acute and chronic chemical eye injury, severe vernal keratoconjunctivitis shield ulcers, after pterygium excision in selected cases, and for ocular surface reconstruction. Cryopreserved tissue is supplied by our partner eye bank.

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Frequently Asked Questions

Is amniotic membrane the same as a corneal transplant?
No. Amniotic membrane is a biological dressing that helps the surface heal — it does not restore vision through clear corneal tissue. A corneal transplant (PK, DALK, DSAEK, DMEK) replaces diseased corneal tissue with healthy donor cornea and is a separate operation.

Where does the amniotic membrane come from?
From the innermost layer of human placentas donated after planned caesarean section, with informed consent from the mother. The tissue is screened for infection, processed under sterile conditions and either cryopreserved or freeze-dried before use. It is non-immunogenic — rejection is not a concern.

Will the membrane stay in my eye forever?
No. A patch typically dissolves over 2–3 weeks. Graft tissue is gradually integrated into the healing cornea or conjunctiva and is no longer a separate layer over the following months.

Does AMT replace antibiotics in infectious ulcers?
No. AMT is used alongside intensive topical antibiotic, antifungal or antiviral treatment, not instead of it. The membrane provides the surface conditions for healing once the infection is controlled, and reduces inflammation and scarring.

Will my vision return after AMT?
AMT preserves and restores the ocular surface, which is necessary for vision but does not by itself guarantee good final vision — that depends on how much scar or opacity remains in the central cornea. In some patients a corneal transplant is offered months later for visual rehabilitation.

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