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The human amniotic membrane in vitreoretinal surgery: Applications, outcomes and limitations
Matteo Mario Carlà1, Federico Giannuzzi1, Lorenzo Hu1
1Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Rome 00168, Italy; Catholic University "Sacro Cuore", Rome 00168, Italy.
Survey of Ophthalmology
|August 7, 2025
Summary
Human amniotic membrane (hAM) is a valuable tool in vitreoretinal surgery for complex conditions like macular holes and retinal detachments. It shows high success rates, with varying efficacy based on preparation and placement technique.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Surgical Innovation
Background:
- Human amniotic membrane (hAM) is increasingly utilized in vitreoretinal surgery.
- Its application has expanded beyond initial uses for macular holes (MHs) to various complex retinal conditions.
Purpose of the Study:
- To review the development and current applications of hAM in vitreoretinal surgery.
- To assess hAM's efficacy in treating conditions including MHs, retinal detachments (RDs) with proliferative vitreoretinopathy (PVR), and optic pit maculopathy.
- To compare cryopreserved versus lyophilized hAM preparations and evaluate subretinal versus epiretinal placement outcomes.
Main Methods:
- Literature review of studies on hAM in vitreoretinal surgery.
- Analysis of anatomical success rates for different indications.
- Evaluation of preparation types (cryopreserved vs. lyophilized) and placement techniques (subretinal vs. epiretinal).
Main Results:
- hAM demonstrates high anatomical success rates (80–95%) for complex vitreoretinal conditions.
- Strong evidence supports its efficacy in refractory MHs (85–100%), myopic MHs with posterior staphyloma (86–92%), and complex RDs with PVR (76–92%).
- Both cryopreserved and lyophilized hAM are effective, but differ in handling and biological properties. Subretinal placement is favored for certain MHs, while epiretinal placement is preferred for PVR and optic pit maculopathy.
Conclusions:
- hAM is a significant therapeutic option for complex vitreoretinal disorders.
- Preparation type and placement technique influence surgical outcomes.
- Further standardization, long-term data, and randomized controlled trials are needed to establish definitive guidelines for hAM use.
