1. Processed Amniotic Membrane Allografts

2. Amniotic Membrane Allografts

7. What Is Human Amniotic Membrane? What Is Human Amniotic Membrane? A unique, avascular membrane separating the mother from the fetus. Provides an incubating environment promoting cellular differentiation. Provides an immunological barrier to prevent “foreign body” rejection.

8. Anatomical Profile: AM Anatomical Profile: AM

9. Anatomy of the Ocular Surface Anatomy of the Ocular Surface (1) Conjunctival Epithelium (2) Corneal Epithelium (6) Limbus – Stem Cells

10. History of AM in Ophthalmology History of AM in Ophthalmology De Rotth. conjunctival defects (1940). Lavery. lime burn of conjunctiva and cornea (1946). Sorsby et al. caustic soda burns (1947). ALLOTRANSPLANTAT [late 80’s USSR->Venezuela, DR] Batlle and Perdomo. Conjunctival substitute with placental allotransplant. Scientific Poster 25. American Academy of Ophthalmology meeting. Chicago, IL USA. October 1993. Kim and Tseng. Transplantation of preserved human amniotic membrane for surface reconstruction in severely damaged rabbit corneas. Cornea 14:473-84, 1995. [

11. Surgical Indications: AM Pterygium Excision Corneal Ulcerations/Perforations Chemical/Thermal Burns Bullous Keratopathy Ocular Dermoids/Tumors Fornix Reconstruction/Symblepharon Stem Cell Transplants

12. Pterygium A mutated growth on the surface of the eye Requires surgical excision and placement of graft

13. Corneal Ulcerations/perforations A break or defect in corneal epithelium Often secondary to other systemic diseases.

14. Chemical/thermal Burns Chemical burns often caused by alkali Potentially devastating trauma to surface of the eye Limbal graft possibly indicated

15. Bullous Keratopathy Edema of the corneal endothelium Very common and usually affects individuals over 50 years of age.

16. Dermoid/tumor Removal Benign congenital tumors containing foreign tissue Commonly found at the limbus

17. Fornix Reconstruction Fibrous tract that connects bulbar conj to conj of eyelid Secondary to other acquired or traumatic conditions Required reconstruction of ocular surface and eyelids

18. Surgical Techniques: Amt/pterygium

19. Ambiodry 2 Overview Tested & Safe Dehydrated Terminally Sterilized Strict, quality- controlled protocols Device-like quality

20. AmbioDry: Safe & Viable Intact epithelial cell layer Intact dense connective, basement membrane Presence of loose fibroblast network

21. AmbioDry: Logistical Features Storage: Room-temp No freezer required No dry ice shipments Simple prep: No soaks or rinses IOP Customer Service: 24 Hrs/7 Days

22. AmbioDry: Surgical Advantages Substrate-free Dry-state handling & trimming Visual orientation identification No tears or buttonholes Device-like tissue quality

23. AmbioDry Configurations 1 x 2 cm 2 x 3 cm 4 x 4 cm

24. Reimbursement Codes Supply code: V2790 CPT code: 65780 ocular surface reconstruction; Amniotic membrane transplantation

25. AmbioDry & Tisseel The sutureless approach to eye surgery. Fibrin (biological) adhesive Eliminates sutures Reduces surgical time Improved patient care Better healing

26. AmbioDry & Tisseel Video