October 21, 2015

Quality Healing in Chronic Dry Eye Patients

published on October 21, 2015 by Brandon Rodriguez, MD

The majority of patients I see in my anterior segment-focused practice who have Dry Eye are either referred for cataract surgery or are patients who have sought treatment elsewhere without success. When these patients present with dryness-related keratitis, such as superficial punctate keratopathy (SPK) that doesn’t respond to initial therapies, I turn to Prokera®, a biologic corneal bandage composed of a cryopreserved amniotic membrane. Its natural therapeutic effects reduce inflammation, promote healing and minimize the risk of scarring, all of which are necessary to alleviate symptoms, return the ocular surface to a normal state and optimize cataract surgery (and LASIK) outcomes.

I began using Prokera in 2010 and have used it extensively for patients with a variety of ocular surface indications with much success. It is easily inserted in my office and patients can continue to use drops which is beneficial, and on average most patients have it in removed after 4 to 7 days with improved visual acuity.

In my practice, I see a fair number of patients with keratopathy secondary to Dry Eye. As a result, I independently initiated a retrospective chart review of 39 patients that were treated with Prokera,  and presented the results at the ASCRS meeting earlier this year. On average, these patients had received 294 days of treatment for dry eye without an adequate response before coming to see me. Inflammatory changes on their corneas were still evident. Within 5.3 days of receiving Prokera, 94.9% of the patients had complete resolution of their keratopathy. Their average visual acuity had been 20/180 before Prokera, and improved dramatically to 20/57 after Prokera.

For my patients whose chronic Dry Eye has progressed to keratopathy this has worked impressively, and the rapid resolution of symptoms and improvement of visual acuity are major advantages for these types of patients.

For similarly affected patients who need cataract surgery, results have been dramatic as well. Prokera rejuvenates the ocular surface when other treatments could not, sometimes changing preoperative K values to the point where a patient does not require a toric IOL as previously thought and leading to excellent patient satisfaction with results.

In my opinion, the cryopreserved amniotic membrane Prokera has clinically proven to be an efficient, cost-effective treatment option as compared to months of other daily therapies that produce less satisfactory results. This is especially true for premium IOL patients who have very high expectations for outstanding outcomes.

Brandon Rodriguez, MD, specializes in advanced cataract and refractive surgery, and is also a cornea trained surgeon specializing in pterygium surgery and cutting edge treatments for dry eye syndrome. He is in practice at St. Luke’s Cataract & Laser Institute, and is an affiliate Associate Professor of Ophthalmology at the University of South Florida, Tampa, FL.

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