Ringless 3-Layer Amniotic Membrane Improves Chronic Ocular Surface Disease  

A ringless 3-layer amniotic membrane may offer vision and symptom improvements for individuals with ocular surface disease who are unable to obtain relief through traditional therapies.

A ringless 3-layer amniotic membrane graft may improve best-corrected visual acuity (BCVA) and chronic ocular surface disease (OSD) symptoms, according to a poster presented at the American Optometric Association 2023 ePosters Virtual Event from June 13-14, 2023 in Washington, DC.

“More than 7 million people suffer from moderate to severe OSD that leads to failure of traditional therapies including artificial tears, punctal occlusion, and immunomodulators,” the report explains. “Approximately 25% of patients feel dissatisfied with their treatment and 37% have intermittent discomfort.”

The researchers, which included Harmin Chima, OD, and Michele Cianciolo, OD, enrolled 16 patients (eyes, 18; mean age, 64.1 years; 9 men) with a history of OSD in the study, including patients with dry eye disease (DED) with superficial punctate keratitis (n=7 eyes), recurrent corneal erosion (n=5 eyes), and band keratopathy (n=6 eyes).

During the baseline visit, investigators administered the Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire and performed BCVA assessment. The participants underwent treatment with the novel, ringless 3-layer amniotic membrane, which was placed on the cornea under a flat-fitting bandage contact lens with topical antibiotic and steroid treatment. Participants underwent SPEED questionnaire and BCVA reassessments at a follow-up visit conducted 5 to 7 days after the baseline visit.

Overall, the research team collected pre and post treatment visual acuity for 15 eyes and SPEED scores for 9 participants. The mean follow-up was 5.7 days after graft placement. Both SPEED scores and BCVA improved following treatment with the ringless 3-layer amniotic membrane, the report shows. Baseline SPEED scores improved from 9.9 to 3.6, and all participants with a BCVA worse than 20/25 experienced vision improvements following the treatment.

The poster presenters highlight the accessibility of this treatments, stating that it “may be applied in the office to improve BCVA, and both symptoms and signs caused by chronic OSD.”


Chima H, Cianciolo M. Pilot evaluation of Biovance® 3-layer amniotic membrane graft for ocular surface disease. Poster presented at: American Optometric Association 2023 ePosters Virtual Event; June 13-14, 2023; Washington, DC.