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.
摘要:
羊膜(AM)具有抗炎作用,抗纤维化,和再生效应。无重复冷冻保存的AM移植,ProKera®(生物组织,Inc.,迈阿密,FL,美国),很容易被眼科医生应用于眼表疾病的治疗。这项回顾性研究包括2022年1月至2023年5月期间接受ProKera®治疗的眼表疾病患者。包括6例患者(9只眼),平均年龄为56.8±20.8岁(范围25-74),平均随访期为7.8±4.1个月(范围1-12)。包括2例复发的结膜肿瘤伴角膜缘和角膜受累(病例1-2),1例翼状胬肉伴明显散光(病例3)和3例Stevens-Johnson综合征(SJS,案例4-6)。在病例1-3中,在病灶切除和深层角膜切除术后插入ProKera®,没有发现复发或角膜并发症。病例4-5从重症监护病房出院,并出现严重的慢性SJS。大多数眼部表现在释咽和ProKera®插入后显著改善,除了1只眼的角膜结瘤(病例5)。病例6涉及急性SJS期间在床边早期使用ProKera®,导致完整的决议。我们得出的结论是,ProKera®的辅助应用可以有效地进行眼表重建,并为门诊患者或不稳定的侵入性手术干预患者提供了早期干预的选择。