March 1, 2016

If It Walks, Talks, and Looks Like a Duck, Then It Must Be RCE…

published on March 01, 2016 by Seema Nanda, OD 

As many of your patients can attest to, the dreaded “Freddy-Krueger-fingernail”, Recurrent Corneal Erosion syndrome (RCE), is unfortunately quite common in our daily practice. We always treat these patients with the classic bandage contact lens (BCL) and sodium chloride drops in hopes that this will solve their problem. However, the dilemma ensues when the abrasion persists incessantly never to heal properly again. So we ask, is it possible to prevent this type of recurrence to rid the cornea of all future erosions forever? Thankfully, with the advent of cryopreserved amniotic membrane, a reversal of this misfortune is now conceivable. Our clinic has been fortunate enough to resolve this conundrum through the use of Prokera® as highlighted in the below case.

A 38-year-old Black male with a history of Corneal Lattice Dystrophy undergoes multiple bouts of epithelial erosions. His condition is complicated by ocular surface disease and Kerato-Conjunctivitis Sicca (KCS). Due to the chronic nature of his condition, these episodes have always waxed and waned throughout the course of his lifetime. He has also grown accustomed to a regimen of BCLs, artificial tears, and antibiotic drops. However this time, we decided to implement a cryopreserved amniotic membrane instead. At his initial visit, the typical feature of Lattice was evident, but upon fluorescein instillation, an erosion in the image of a duck appeared. The cornea was “quack-ing” for relief, so the Prokera was placed over the abrasion as we awaited the treatment to take effect. At his final follow-up visit two weeks later, inflammation on the cornea had decreased greatly and the eye no-longer made duck calls. For the first time in his life, he is both hopeful and optimistic that future occurrences may be lessened to a great extent.

The incredible cure of RCE using Prokera is clearly exemplified in these cases. In addition, seldom does one see any new product or drug not only relieve the patient’s symptoms completely, but also resolve their corneal condition as well. Our facility has been privileged to see hundreds of these miraculous cases on a daily basis and wanted to share this success so that others may benefit from this phenomenal discovery as well.

Seema Nanda, OD works alongside a corneal specialist at a hospital-based ophthalmology clinic in Houston, Texas. She concurrently teaches as a Clinical Professor in the Cornea and Contact Lens Service at the University of Houston College of Optometry.

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