Self-Retained, Sutureless Amniotic Membrane Transplantation for the Management of Ocular Surface Diseases

Abstract

Amniotic membrane (AM) has anti-inflammation, anti-fibrotic, and regenerative effects. Sutureless cryopreserved AM transplantation, ProKera® (Bio-Tissue, Inc., Miami, FL, USA), is easily applied by ophthalmologists in the treatment of ocular surface diseases. This retrospective study included patients with ocular surface diseases who received ProKera® between January 2022 and May 2023. Six patients (9 eyes) with a mean age of 56.8 ± 20.8 years old (range 25–74) and a mean follow-up period of 7.8 ± 4.1 months (range 1–12) were included, including 2 of recurrent conjunctival tumors with limbal and corneal involvement (cases 1–2), 1 of pterygium with marked astigmatism (case 3) and 3 of Stevens–Johnson syndrome (SJS, cases 4–6). ProKera® was inserted after the lesion excision and deep keratectomy in cases 1–3, and no recurrence or corneal complication was noted. Cases 4–5 were discharged from the intensive care unit and presented with severe chronic SJS. Most ocular manifestations improved significantly after symblepharon release and ProKera® insertion, except for corneal conjunctivalization in 1 eye (case 5). Case 6 involved early ProKera® use at the bedside during acute SJS, resulting in complete resolution. We concluded that the adjunctive application of ProKera® can be effective for ocular surface reconstruction and provides options to intervene earlier for outpatients or patients unstable for invasive surgical intervention.

Keywords

• amniotic membrane transplantation
• ProKera^®
• cryopreserved
• cornea surface disease
• non-ophthalmologist