title: Sutureless cryopreserved amniotic membrane graft and wound healing after photorefractive keratectomy.
abstract: OBJECTIVE
  To evaluate the effect of sutureless cryopreserved amniotic membrane (Prokera) on corneal wound healing after photorefractive keratectomy (PRK).
  
  
  METHODS
  Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, DC, USA.
  
  
  METHODS
  Prospective nonrandomized control trial.
  
  
  METHODS
  Patients had PRK for myopia with or without astigmatism. A 20% ethanol solution was used to create a standard 9.0 mm epithelial defect followed by photoablation with the Allegretto Wave Eye-Q 400 Hz laser. After surgery, a high-oxygen-transmissible bandage contact lens (Acuvue Oasys) was applied on the dominant eye and cryopreserved amniotic membrane on the nondominant eye. The postoperative regimen was otherwise identical for both eyes. Postoperatively, patients were evaluated daily until complete corneal reepithelialization occurred in both eyes and then at 2 weeks and 1, 3, 6, and 12 months. Reepithelialization was assessed daily with slitlamp examination, fluorescein staining, and photography. Secondary outcome measures included adverse effects, ocular comfort, visual outcomes, and corneal haze.
  
  
  RESULTS
  Forty patients were enrolled. The amniotic membrane graft sped corneal reepithelialization 1 day after PRK but was not better than the bandage contact lens in hastening complete reepithelialization of the cornea. Visual outcomes, corneal clarity, and optical quality of the cornea were comparable between the amniotic membrane graft eyes and bandage contact lens eyes.
  
  
  CONCLUSIONS
  Although the amniotic membrane graft was reasonably well tolerated with few significant adverse effects, the role of amniotic membrane in modulating wound healing after PRK remains speculative.
authors.affiliation: From the Ophthalmology Service (Vlasov, Stutzman), Walter Reed National Military Medical Center, Bethesda, Maryland, the Warfighter Refractive Eye Surgery Program and Research Center (Sia, Ryan, Rivers), Fort Belvoir, Virginia, the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, the Ocular Surface Center and Ocular Surface Research & Education Foundation (Tseng), Miami, Florida, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA. Electronic address: antvlasov@gmail.com.
authors.forename: Anton
authors.initials: A
authors.lastname: Vlasov
authors.affiliation: From the Ophthalmology Service (Vlasov, Stutzman), Walter Reed National Military Medical Center, Bethesda, Maryland, the Warfighter Refractive Eye Surgery Program and Research Center (Sia, Ryan, Rivers), Fort Belvoir, Virginia, the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, the Ocular Surface Center and Ocular Surface Research & Education Foundation (Tseng), Miami, Florida, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Rose K
authors.initials: RK
authors.lastname: Sia
authors.affiliation: From the Ophthalmology Service (Vlasov, Stutzman), Walter Reed National Military Medical Center, Bethesda, Maryland, the Warfighter Refractive Eye Surgery Program and Research Center (Sia, Ryan, Rivers), Fort Belvoir, Virginia, the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, the Ocular Surface Center and Ocular Surface Research & Education Foundation (Tseng), Miami, Florida, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Denise S
authors.initials: DS
authors.lastname: Ryan
authors.affiliation: From the Ophthalmology Service (Vlasov, Stutzman), Walter Reed National Military Medical Center, Bethesda, Maryland, the Warfighter Refractive Eye Surgery Program and Research Center (Sia, Ryan, Rivers), Fort Belvoir, Virginia, the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, the Ocular Surface Center and Ocular Surface Research & Education Foundation (Tseng), Miami, Florida, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mines
authors.affiliation: From the Ophthalmology Service (Vlasov, Stutzman), Walter Reed National Military Medical Center, Bethesda, Maryland, the Warfighter Refractive Eye Surgery Program and Research Center (Sia, Ryan, Rivers), Fort Belvoir, Virginia, the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, the Ocular Surface Center and Ocular Surface Research & Education Foundation (Tseng), Miami, Florida, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Stutzman
authors.affiliation: From the Ophthalmology Service (Vlasov, Stutzman), Walter Reed National Military Medical Center, Bethesda, Maryland, the Warfighter Refractive Eye Surgery Program and Research Center (Sia, Ryan, Rivers), Fort Belvoir, Virginia, the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, the Ocular Surface Center and Ocular Surface Research & Education Foundation (Tseng), Miami, Florida, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Rivers
authors.affiliation: From the Ophthalmology Service (Vlasov, Stutzman), Walter Reed National Military Medical Center, Bethesda, Maryland, the Warfighter Refractive Eye Surgery Program and Research Center (Sia, Ryan, Rivers), Fort Belvoir, Virginia, the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, the Ocular Surface Center and Ocular Surface Research & Education Foundation (Tseng), Miami, Florida, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Scheffer C G
authors.initials: SC
authors.lastname: Tseng
authors.affiliation: From the Ophthalmology Service (Vlasov, Stutzman), Walter Reed National Military Medical Center, Bethesda, Maryland, the Warfighter Refractive Eye Surgery Program and Research Center (Sia, Ryan, Rivers), Fort Belvoir, Virginia, the Ophthalmology Service (Mines), Madigan Army Medical Center, Tacoma, Washington, the Ocular Surface Center and Ocular Surface Research & Education Foundation (Tseng), Miami, Florida, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Kraig S
authors.initials: KS
authors.lastname: Bower
mesh_terms: D000328:Adult; D000650:Amnion / Q000637:transplantation*; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D015925:Cryopreservation; D019573:Epithelium, Corneal / Q000502:physiology; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy; D011446:Prospective Studies; D062326:Re-Epithelialization / Q000502:physiology; D012029:Refraction, Ocular; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000502:physiology*