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Christina Giannikas, Ira J Udell, Anne Steiner, Carolyn Shih; Sutureless Amniotic Membrane Transplantation for Ocular Surface Disorders: A Comparison of ProKera to AmbioDisc. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4707.
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To evaluate and compare the indications and outcomes of two types of sutureless amniotic membrane transplantation (AMT), ProKera and AmbioDisc, in the management of ocular surface disorders.
Retrospective chart review of all patients who had ProKera (Bio-Tissue, Inc.) or AmbioDisc (IOP Ophthalmics, Inc.) application for ocular surface disorders between August 2010 and November 2013 at a tertiary medical center’s cornea practice. The parameters evaluated included age, sex, indication for AMT, effect of amniotic membrane on ocular surface healing, and tolerance. Complete success was defined as complete healing of the ocular surface without further intervention, partial success was defined as partial healing of the ocular surface requiring further intervention (BCL, tarsorrhaphy, conjunctival flap), and failure was defined as lack of documented improvement with transplant or premature discontinuation of transplant prior to demonstrable improvement. Any complications were noted.
22 eyes of 20 patients with a mean age of 75.5 years (Range 25-93 years) were evaluated. 73% were male. 64% of eyes were treated with ProKera and 36% were treated with AmbioDisc. Indications for AMT were nonhealing infectious corneal ulcer (ProKera 21%, AmbioDisc 13%), neurotrophic keratopathy (ProKera 43%, AmbioDisc 25%), nonhealing epithelial defect over previous corneal transplant (ProKera 14%, AmbioDisc 63%), and other (ProKera 21%, AmbioDisc 0%). Overall success (complete or partial) was seen in 68% of eyes (ProKera 64%, AmbioDisc 75%). Complete success was seen in 45% of eyes (ProKera 43%, AmbioDisc 50%), and partial success was seen in 23% of eyes (ProKera 21%, AmbioDisc 25%). Of the patients who went on to require further intervention, 14% were treated with BCL (ProKera 7%, AmbioDisc 25%), 23% with tarsorrhaphy (ProKera 29%, AmbioDisc 13%), and 18% with conjunctival flap (ProKera 29%, AmbioDisc 0%). Patient intolerance was observed in the ProKera group in 7/14 eyes (50%). 1 patient with neurotrophic keratits developed recurrence of a hypopyon 2 days after placement of AmbioDisc.
ProKera and AmbioDisc are both successful in promoting healing in a variety of ocular surface disorders. While they had similar success rates, ProKera had the limitation of patient intolerance in half of cases. The incidence of deleterious side effects was minimal with both modalities.
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