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Self-Retained Cryopreserved Amniotic Membrane for the Management of Corneal Ulcers

Authors Brocks D, Mead OG, Tighe S, Tseng SCG

Received 13 March 2020

Accepted for publication 5 May 2020

Published 26 May 2020 Volume 2020:14 Pages 1437—1443


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Daniel Brocks,1 Olivia G Mead,2 Sean Tighe,3,4 Scheffer CG Tseng2

1BostonSight, Needham, MA, USA; 2Ocular Surface Center and TissueTech Inc, Miami, FL, USA; 3Department of Ophthalmology, Florida International University, Miami, FL, USA; 4Department of Biochemistry and Molecular Biology, University of Miami, Miami, FL, USA

Correspondence: Daniel Brocks
BostonSight, 464 Hillside Ave Suite 205, Needham, MA 02494, USA
Tel +1 781 726 7337

Purpose: To evaluate the clinical outcomes of self-retained cryopreserved amniotic membrane (cAM) for the treatment of corneal ulcers.
Methods: This was a single-center, retrospective review of consecutive patients with non-healing corneal ulcers that underwent treatment with self-retained cAM (PROKERA® Slim). The primary outcome measure was time to complete corneal epithelialization. Ocular discomfort, corneal staining, corneal signs, and visual acuity were assessed at 1 week, 1 month, 3 months, and 6 months. Complications, adverse events, and ulcer recurrence were also recorded.
Results: A total of 13 eyes (13 patients) with recalcitrant corneal ulcers were included for analysis, 9 (69%) of which progressed from neurotrophic keratitis (NK). Prior to cAM application, patients used conventional treatments such as artificial tears (n = 11), antibiotics (n = 11), ointment (n = 11), steroids (n = 6), and antivirals (n = 3). Self-retained cAMs (n = 1.5 ± 0.8) were placed for 6.8 ± 3.4 days, during which time antibiotics were continued. Four cases (31%) were subsequently treated with bandage contact lens (n = 3) and tarsorrhaphy (n = 1). All corneal ulcers healed in a median of 14 days (range: 4– 43). This was accompanied by a significant improvement in ocular discomfort, corneal staining, and corneal signs at 1 week, 1 month, 3 months, and 6 months (P<.05). Recurrence was noted in one case. No adverse events were observed.
Conclusion: Self-retained cAM may be a valuable, in-office treatment option for healing recalcitrant corneal ulcers of various etiologies, especially those with underlying NK. Further prospective, controlled studies are warranted.

Keywords: amniotic membrane, corneal ulcer, neurotrophic keratitis, ocular surface disease

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