Sutureless amniotic membrane ProKera for ocular surface disorders: short-term results.
OBJECTIVE
To evaluate the indications and outcomes of sutureless amniotic membrane transplant (AMT; ProKera) in the management of ocular surface disorders.


METHODS
Chart review of patients who had ProKera (Bio-Tissue, Inc.) implantation for ocular surface disorders between June 2008 and May 2012 at 3 ophthalmology practices in Philadelphia, PA. The parameters evaluated included age, sex, indication for AMT, any other combined procedure, duration of retention of amniotic membrane, the effect of amniotic membrane on ocular surface healing, follow-up time, and complications.


RESULTS
There were 35 eyes of 33 patients with a mean age of 68.2±19.5 years (range: 17-99 years). There were 25 male patients, and median follow-up was 110 days (mean: 164.6 days; range: 30-960 days). The indication for insertion of ProKera was nonhealing corneal ulcers of infective origin (group 1) in 9 eyes (25.7%), neurotrophic keratopathy (group 2) in 11 eyes (31.4%), chemical injury (group 3) in 5 eyes (14.3%), and other indications (group 4) in 10 eyes (28.6%). Complete or partial success was seen in a total of 44%, 64%, 80%, and 70% eyes in groups 1 to 4, respectively. Discomfort with the device was seen in 6 (17.1%) of 35 eyes, and recurrence of primary pathologic condition occurred in 5 (14.3%) of 35 eyes.


CONCLUSIONS
ProKera treatment is easy to use and reasonably well tolerated, with moderate success in corneal ulcers and encouraging results in acute moderate chemical injury. Recurrence of primary pathologic condition is seen particularly associated with neurotrophic keratitis and dry eye syndrome.
Cornea Service, Wills Eye Institute, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
Kunal
K
Suri
Mustafa
M
Kosker
Irving M
IM
Raber
Kristin M
KM
Hammersmith
Parveen K
PK
Nagra
Brandon D
BD
Ayres
Colleen P
CP
Halfpenny
Christopher J
CJ
Rapuano
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion / Q000637:transplantation*; D002057:Burns, Chemical / Q000601:surgery; D003316:Corneal Diseases / Q000601:surgery*; D003320:Corneal Ulcer / Q000601:surgery; D005126:Eye Burns / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D055815:Young Adult