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Ankur A Parikh, Siri Yalamanchili, David Gemmel, Sergul Erzurum; Dehydrated Extracellular Membranes in the Treatment of Severe Dry Eye. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6754.
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Dry eye can severely affect a patient’s quality of vision and life. Common symptoms include redness, burning, and blurred vision. Even with multiple treatment options, some patients have persistent difficulty. In recent years, amniotic membranes have become a treatment option for a variety of ocular surface disorders including corneal ulcers, neurotrophic keratopathy, and chemical injury. The objective of this study is to evaluate the efficacy of dehydrated amniotic membrane (BioDOptix) use in patients with dry eye.
A retrospective chart review of patients receiving dehydrated amniotic membranes for severe dry eye in the past two years was conducted. Patients with other complicating eye diagnoses were excluded. Data on visual acuity, symptoms, and slit lamp examination (SLE) findings were collected prior to lens placement, 1-week, and 1-month after removal. A symptom count checklist of 14 items was summed to create an index, ranging from 0-14. A paired t-test was used to assess significant change at each interval.
Chart audit yielded 28 eyes in 20 patients with an average patient age of 68+16 years. Prior to membrane treatment, therapies included natural tears (21/28), punctal plugs (18/28), Restasis®(13/28), Xiidra®(7/28), serum tears (4/28), and others (12/28).At baseline, symptom count index was 1.4+1.0. Symptoms were 0.9+1.0 (t test = 2.478, p = 0.02) at one week and 0.6+1.0 at one month (t = 2.087, p = 0.054), demonstrating significant sustained reduction from baseline. Punctate epithelial erosions (PEE), measured on a scale of 0 – 4, were 2.8 +1.1 at baseline (n = 27). PEEs improved to 0.7 +0.8 at one week (t = 7.39, p < 0.001) and were sustained at one month, 0.6 +0.8 (t = 6.816, p < 0.001). LogMAR <0.1 visual acuity was 21% (6/28) at baseline. At 1 week, LogMAR <0.1 was similar to baseline, 22% (6/27). By 1-month, logMAR <0.1 increased to 50% (8/16); however, visual acuity was not statistically significant.
BioDOptix membranes have the advantage of being easily applied in an outpatient setting and patients find these lenses comfortable and easy to leave in place. BioDOptix membranes showed a significant rapid reduction in both symptoms and PEEs as well as an improvement in visual acuity. Thus, dehydrated amniotic membranes should be considered in the armamentarium to manage patients with difficult dry eye.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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