Supplies for Performing AMT for Corneal Indications

Cryopreserved Amniotic Membrane (AM) grafts:

Cryopreserved AM grafts are used to treat corneal defects because while cryopreservation kills allogeneic cells in the AM eliminating the need for immunosuppression, it maintains the integrity of the cytokine-rich extracellular matrix which provides biological actions that help reduce corneal haze and aid in ocular surface wound repair and wound healing. To learn more about amniotic membrane click here.

AMNIOGRAFT®, distributed by Bio-Tissue, Inc. (Miami, FL), is available in 4 sizes. The standard size to cover the cornea is 2.5 x 2.0 cm (Catalog # AG-2520). To cover only part of the cornea, the 2.0 x 1.5 cm (Catalog # AG-2015) can be used and if more than the cornea needs to be covered a 3.5 x 3.5 cm size (Catalog # AG-3535) can be used.

 Click here to see a video on handling AMNIOGRAFT.

PROKERA™, distributed by Bio-Tissue, Inc., is a device that contains AMNIOGRAFT^® clipped into a polycarbonate ring set conformer manufactured so the stromal side of the tissue is in contact with the corneal and limbal surface. This device can be inserted under the patient’s eye lids in the office or in the OR setting without the need for sutures or fibrin glue. There are two different diameters of PROKERA™ available: 15 mm (Catalog # PK-15) and 16 mm (Catalog # PK-16). Most adult patients will tolerate a 16-mm device. After epithelial healing is completed, the membrane is dissolved and the PROKERA™ ring set can be removed.

                                           Click here to view a written guide on the use of ProKera. 
                                           Click here to view a video on the use of ProKera.

Fibrin Glue:

Tisseel^®, distributed by Baxter Biologics, Inc., is recommended over other fibrin glues because of the quick setting time. Tisseel^® requires pre-warming in a thermal/stirrer provided without costs by the manufacturer. The recommended size is 2.0 mL (Catalog #: 1501236).

Click here to view more Tisseel information.

Topical Aesthesia:

0.5% proparacaine hydrochloride, 0.5% tetracaine hydrochloride, or 2% xylocaine jelly (AstraZeneca) is used for PROKERA™ insertion and for most of the surgeries described here.

Sutures:

AMT is conventionally performed using sutures. If fibrin glue is not used, AMNIOGRAFT^® can be secured using several interrupted 10-0 nylon sutures on peri-limbal bulbar conjunctiva and by 8-0 Vicryl sutures in a mattress fashion, parallel to the fornix, with solid episcleral bites to seal the fornix border.