Diagnostic and Surgical Technique

The amniotic membrane is the innermost of the three layers forming the fetal membranes. It was first used in 1910 in skin transplantation. Thereafter it has been used in surgical procedures related to the genito-urinary tract, skin, brain, and head and neck, among others. The first documented ophthalmological application was in the 1940s when it was used in the treatment of ocular burns. Following initial reports, its use in ocular surgery abated until recently when it was re-discovered in the Soviet Union and South America. Its introduction to North America in the early 1990s heralded a massive surge in the ophthalmic applications of this membrane. The reintroduction of amniotic membrane in ophthalmic surgery holds great promise; however, although it has been shown to be a useful and viable alternative for some conditions, it is currently being used far in excess of its true useful potential. In many clinical situations it offers an alternative to existing management options without any distinct advantage over the others. Further studies will undoubtedly reveal the true potential of the membrane, its mechanism(s) of action, and the effective use of this tissue in ophthalmology. (Surv Ophthalmol 49:51–77, 2004. ! 2004 Elsevier Inc. All rights reserved.)