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Tala Marie Kassm, Roxana Ursea; The Value of Amniotic Membrane Patch in the Treatment of Corneal Thinning as Assessed by Anterior Segment Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2466.
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To assess the efficacy of sutureless amniotic membrane in the treatment of corneal thinning with and without epithelial defect using anterior segment optical coherence tomography (AS-OCT).
Retrospective non comparative interventional case series. Fifteen eyes of thirteen patients received a sutureless, adhesive less amniotic membrane patch (ProKera, BioTissue, Inc., Miami, FL) for the treatment of corneal thinning with persistent epithelial defect, PED, (seven eyes) and without epithelial defect (eight eyes). Corneal response to this patch was measured by AS-OCT (Visante OCT, Carl Zeiss Meditec, Dublin, CA). The Underlying etiologies included infectious keratitis (five eyes), rheumatoid arthritis (four eyes), Sjogren syndrome (two eyes), penetrating keratoplasty graft rejection (two eyes), chemical burn (one eye), recurrent corneal ulcers (two eyes), and severe dry eye syndrome (two eyes).
Corneal thickness was restored in all eyes with epithelial defect. After ProKera wear for a mean period of 14.6 ± 5.2 days, corneal thickness increased 132 ± 64 μm by AS-OCT within one to four weeks of treatment in eyes with PED and within six weeks in those without defects. Duration of effect was at least 8.2 ± 5.3 months. Re-epithelialization occurred within one week in 75% of PED. Associated inflammation, pain and photophobia all decreased.
ProKera is a convenient device that can easily be used to manage corneal thinning and PED. Interestingly, it also showed promise in restoring corneal thickness in select eyes without epithelial defect. AS-OCT was useful for quantifying ProKera’s clinical efficacy.
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