UK Hospitals present their innovations of amniotic membrane transplantation in the management of ocular surface disease

The webinar launched Tuesday 2^nd November, 7PM GMT with the introduction of Mr. Mohamed Elalfy, a consultant ophthalmic surgeon at the Queen Victoria Hospital NHS Trust and Maidstone and Tunbridge Wells NHS Trust, who chaired the meeting and announced the theme of the teaching session.

First to take to the virtual floor was Mr. Vito Romano, a consultant ophthalmic surgeon, previously based at the Liverpool University Hospitals NHS Trust and now based in Milan, Italy. Mr. Romano’s talk titled the “use of amniotic membrane in corneal perforation” began noting the background details of corneal perforation, which can arise due to range of factors including infection, inflammation, or disease of various aetiologies, such as endophthalmitis, glaucoma or cataract. Mr. Romano’s team have developed a technique which involves placing a multilayer amniotic membrane graft into the perforation, covering it with a layer of cyanoacrylate glue, and then placing an amniotic membrane patch over the periphery of the wound to protect the graft from movement or displacing the glue layer. The patient would then have a bandage contact lens (BCL) of 20-22 mm in diameter placed on the ocular surface. Mr. Romano presented a range of slit lamp and OCT images of a patient treated with this technique to highlight its success. He emphasised the requirement to act quickly when treating corneal perforations and stated that having malleable dried amniotic membrane matrix, such as Omnigen®, on the shelf is a benefit. Mr. Romano noted that patients who can be treated with a contact lens and dried amniotic membrane is acceptable for a specific group of patients.

The second talk was given by Mr. Nick Kopsachilis, a consultant ophthalmic surgeon at the Kent and who presented a two-fold presentation titled “use of Omnigen in a complex ocular surface patient and in a novel sutureless pterygium technique”. In the first part of the talk Mr. Kopsachilis presented a case of a 73-year-old patient with a persistent epithelial defect, with corneal thinning and pending perforation. Mr. Kopsachilis and team treated the patient with an inlay amniotic membrane graft paired with a bandage contact lens and presented the OCT images of the healing outcome. This was a novel, glue-less, and sutureless technique that was performed in an outpatient setting. Secondly, Mr. Kopsachilis detailed the treatment of pterygium in patients with a novel surgical technique, which is both sutureless and glue-less. It involves transplanting amniotic membrane onto the bare sclera left due to the resected pterygium and placing a bandage contact lens to protect the wound. Mr. Kopsachilis presented the results of a series of 63 patients.

The final speaker was Dr. Sundas Maqsood. In the talk named “use of human amniotic membrane derived dry matrix in ocular surface disorders”, she began noting the background of amniotic membrane and followed up with details of a case series of > 90 patients of various aetiologies, who were treated with outpatient amniotic membrane to aid the resolution of persistent epithelial defects. Dr. Maqsood closed her talk speaking about the ongoing, new research that herself and the team across Maidstone and Tunbridge Wells NHS Trust and the Queen Victoria Hospital NHS Trust have been conducting. This upcoming research is looking at the treatment of patients with a range of inflammatory disorders and Dr. Maqsood is also working with AOS – Advanced Ophthalmic Solutions (https://aos-hub.com), a specialised imaging company to image and track the patients outcomes.

After this, all speakers were involved in a question-and-answer session led by Mr. Elalfy on various aspects of their research. The webinar was sponsored by NuVision Biotherapies Ltd (www.nu-vision.co.uk) who manufacture Omnigen, a human-derived amniotic membrane tissue that is preserved using the Tereo® manufacture process. This allows the amniotic membrane to be preserved as a dry membrane that can be stored between 2 – 25^oC and can be rehydrated in vivo. Amniotic membrane is transplanted in ophthalmic subgroups due to its barrier properties that support the natural healing of the ocular surface.

NuVision would like to send their warmest thanks to all speakers and attendees for joining and providing an interesting and fruitful environment to discuss the recent innovations in amniotic membrane use. To catch-up on all aspects from the webinar, please contact support@nu-vision.co.uk who will gladly provide access to the video recording of session.