this video is going to be a little bit special because i got my hands on a prokera
amniotic membrane i'm going to demonstrate exactly what it looks like on a patient's eye
how to put it in take it out what it might feel like because amniotic
membranes are amazing at treating moderate to severe dry eye symptoms and not just that
it has a wide variety of conditions that it can treat with amazing results let's focus in
hey howdy everybody this is dr neal guymon, dr eyeguy and i do videos all about the eyes
to help you with your eyes and we're going to go over exactly what amniotic membranes are and how
you might benefit from them the first question that most people want to ask is where does the
amniotic membrane actually come from for example the prokera amniotic membrane is prepared from
the placenta donated from a healthy mom after a c-section they're able to take some of that
tissue from the placenta and actually develop a graft that has natural properties in it such as
anti-inflammatory anti-scarring anti-angiogenesis so amazing healing properties that they've made
it into a membrane and amniotic membrane that can be used for treatment now because of this
amniotics fall into the category of biologics where you can use a form of a living organism
or a part of a living organism to treat a disease now there are a few different types of amniotic
membranes out there the one i'm going to use in this video is actually the prokera brand amnionic
membrane it's a fda cleared cryopreserved form of an amniotic membrane and it's actually the form
of amniotic membrane that i've found the best results on my patients but there are also
dehydrated membranes out there they're a little bit smaller sometimes they can be a little bit
more comfortable but those are also available as well now what can amniotic membranes actually be
used to treat and the list on this one is super long in fact i'll put it right here the ones that
you might be interested in definitely relate to moderate to severe dry eye like keratitis
inflammation of the cornea corneal erosions or corneal ulcers corneal abrasions herpetic
lesions chemical burns anything that might need a natural stimulated corneal healing the amniotic
membrane is going to do the trick now how does the amniotic membrane actually work what is it doing
when it's placed over the surface of the eye it will stimulate the natural healing properties
of the cornea it will help that cornea regrow its tissue it will suppress inflammation it
will reduce scarring reduce angiogenesis and also has a little bit of antimicrobial antibacterial
properties in there as well and all of this it does all of this without the side effects
that you might have with eye drops that might be trying to do the same thing so i wanted to
show you an example of a prokera amniotic membrane on a patient's eye and i have a lovely assistant
here that's going to help me do that now a prokera amniotic membrane is a fda cleared cryo-preserved
amniotic membrane so you'll notice the doctor will get it out of the freezer and then the
doctor is going to thoroughly rinse that amniotic membrane before we put it on the patient's eye and
before we get into that definitely look at the description below for any additional information
also if you have any questions about amniotic membranes definitely comment below i try my best
to answer all the questions that i see on the videos now you notice the amniotic membrane is
around a polycarbonate ring and it is pretty big i mean it's definitely bigger than a soft contact
lens and so saying that the patient is definitely gonna be aware of the amniotic membrane in the eye
so there is a little bit of a comfort issue but it shouldn't be painful or anything but
yeah the patient's gonna know it's there now before the doctor puts in the membrane
the doctor will usually numb the eye first just to make it more comfortable now because the membrane
is a little bit bigger the doctor is going to maneuver the eyelids a little bit the patient
will look down while the doctor will place the amniotic membrane underneath the top eyelid the
patient will look up a little bit and that will allow the doctor to place the amniotic membrane
underneath the bottom eyelid now the amniotic membrane should be smooth centered shouldn't move
around too much and should stay right where it needs to right on the center of the eye and then
usually at this point the doctor is going to tape the eyelid down a little bit for a couple reasons
main reason is that it's usually more comfortable when the eyelids down that limits the amount of
movement the eyelid is going to be doing over the amniotic membrane so the patient will be less
aware of the membrane also they're going to tape it down and leave just a little slit left open so
just in case if the patient needs to put eye drops in there they can still get the eye drops in the
eye now you've probably noticed that the membrane is opaque so that means the vision is going to be
blurry while the patient's looking out of it so pretty much that eye is going to be kind
of down and out usually visual acuity is about 20 200 so just make sure when you're doing this
that the other eye is seeing okay and that they can still function so this means that they'll
probably only treat one eye at a time just so you have some vision while you're going about your day
in about three to five days the patient's gonna come back for the removal of the amniotic membrane
now usually by this time the membrane has been absorbed and so all that's left over in the eye
is just that polycarbonate ring that needs to be removed now removing the membrane is a little bit
similar to putting the membrane in you're gonna have the patient look up this time pull the
bottom eyelid down and there is actually a little tool that allows the doctor to actually grab that
membrane and start sliding it out the patient will look down and then the doctor is able to slide the
whole membrane out and then after this is the exciting part because then the doctor is able to
see how well the amniotic membrane did at helping heal the corneal surface helping heal the eye
hey as a thanks to my assistant for letting me demonstrate the amniotic membrane on a patient's
eye hit that like button i know that she'll like it now amniotic membranes definitely can be pricey
they're costly for the doctors costly for the patients but luckily we're finding pretty good
insurance coverage for amniotic membranes and so i think in the future you're going to find more
and more doctors using amniotic membranes just because of the amazing benefits and also pretty
good coverage with insurance now the patients that i've used amniotic membranes are when they come
back about the five-day mark it's actually pretty amazing at the results when we take that ring out
and we look at the cornea it's amazing what you can see how well it will actually heal the cornea
up and a lot of times that healing will remain and the patient will feel great for months and months
to come and so i am definitely a fan of amniotic membranes for sure if you're looking for more
specific dry eye education dry eye symptoms dry eye treatments definitely check out my playlist
of videos right there or another good video right there i'm dr neal guymon, dr eyeguy, stay focused