CAM360 AmnioGraft (CAM360 AG), by BioTissue, features anti-inflammatory, anti-scarring, and antiangiogenic actions to assist in healing conditions, such as mild-to-moderate dry eye disease (DED), superficial punctate kera-titis, and Stage 1 neurotrophic keratitis (NK), says the company. As a result, the cryopreserved, hydrated, shelf-stable, ring-less, and Medicare-covered AG should be in every OD’s ocular surface disease treatment toolbox, say those interviewed for this column.
Therapeutic Effects
The cryopreserved amniotic membrane has been shown to reduce the signs and symptoms of DED, support epithelial adhesion and differentiation, and promote corneal nerve regeneration in patients who have the moderate-to-severe condition, according to research.1
“Studies show the benefits last anywhere between 3 to 6 months,” points out Gina Ciarmiello, OD, who practices at the Center for Eye Care Excellence in Slingerlands, New York. “I’m seeing the same thing in my practice.”2-4
Valerie Barnett, OD, who practices at Texas Vision & Laser Center, a multispecialty practice with several locations in Texas, agrees with Dr. Ciarmiello and cites a specific memorable case:
“I fit an NK patient in the CAM360 AG in a collagen shield, and the patient went from 2.25 cm of reduced corneal sensitivity with NK testing, to normal corneal sensitivity at 5 cm, measured 3-weeks later, with just one 24-hour treatment,” she says. “Also, they maintained that improvement through 6 months.”
Patient Comfort/Convenience
In addition to the therapeutic effects of the CAM360 AG, those interviewed noted patient comfort and convenience with it.
Specifically, CAM360 AG’s adhesive properties help ensure it remains immobile under a collagen shield and takes less time to apply.
“This feature has significantly improved patient comfort,” notes Ahmad M. Fahmy, OD, FAAO, founder of the Twin Cities OSD Symposium and consultative OD at Minnesota Eye Consultants, in Bloomington, Minnesota.
Dr. Barnett points out that the ringless option and reduced treatment time of the CAM360 AG have also made it a convenient treatment option for working-age patients who have DED. “They [working-age patients] appreciate the application process and 1- to 2-day wear,” she says. “I say to the patient, ‘we’re going to do a quick reset to the cornea. It’s only going to be a couple days of downtime.’”
Practice Results
Regarding the effect on one’s practice of offering the CAM360 AG, Dr. Fahmy says, “Patients treated with it often achieve an improvement in their quality of life and share this with their loved ones.”
Pro Tip: Practice makes perfect with application, says Dr. Fahmy. “I have found it much easier and much more efficient to prepare the membrane and collagen shield complex in another exam room and then bring it over to the patient for application, rather than applying it directly to the cornea,” he says.
Dr. Fahmy suggests optometrists be open to different methodologies and protocols with the treatment, depending on the patient; for ex-ample, if they have a really strong blink, or floppy eyelid syndrome or eyelid malposition. OM
References
1. McDonald M, Janik SB, Bowden FW, et al. Association of Treatment Duration and Clinical Outcomes in Dry Eye Treatment with Sutureless Cryopreserved Amniotic Membrane. Clin Ophthalmol. 2023;17:2697-2703. Published 2023 Sep 12. doi:10.2147/OPTH.S423040
2. McDonald MB, Sheha H, Tighe S, et al. Treatment outcomes in the DRy Eye Amniotic Membrane (DREAM) study. Clin Ophthalmol. 2018;12:677-681. Published 2018 Apr 9. doi:10.2147/OPTH.S162203
3. John T, Tighe S, Sheha H, et al. Corneal Nerve Regeneration after Self-Retained Cryopreserved Amniotic Membrane in Dry Eye Disease. J Ophthalmol. 2017;2017:6404918. doi:10.1155/2017/6404918
4. Cheng AM, Zhao D, Chen R, et al. Accelerated Restoration of Ocular Surface Health in Dry Eye Disease by Self-Retained Cryopreserved Amniotic Membrane. Ocul Surf. 2016;14(1):56-63. doi:10.1016/j.jtos.2015.07.003