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TAHOE SUMMIT 2015 Scheffer C. G. Tseng, M.D., Ph.D., FAAO “Placement of PROKERA® for Dry Eye” 1. Introduction A. Dry eye is a common ocular surface disease B. Pathogenesis leading to dry eye: Dissecting the ocular surface defense into (1) compositional deficiency and (2) hydrodynamic deficiency C. Historical evidence and clinical uses of cryopreserved amniotic membrane in managing different ocular surface diseases D. PROKERA is an FDA-approved Class II medical device to deliver cryopreserved amniotic membrane's therapeutic actions, i.e., anti-inflammatory and anti-scarring effects as well as growth-promoting effect, all desirable to promote ocular surface wound healing 2. Clinical Uses of PROKERA A. Review of current indications in different corneal diseases a) Diseases with severe ocular surface damage such as chemical burns and StevensJohnson/Toxic epidermal necrolysis, - Early intervention to avoid the development of limbal stem cell deficiency b) Diseases with pre-existing or persistent corneal epithelial defects such as infection keratitis and neurotrophic keratitis - Early intervention to avoid scarring and reduced vision c) Diseases with abnormal corneal epithelium or subepithelial infiltrates or scarring such as recurrent corneal erosion, epithelium basement membrane dystrophy (EBMD), and Salzmann nodular degeneration - In conjunction with epithelial debridement and/or superficial keratectomy to promote rapid healing and restore vision d) Keratitis due to exposure and moderate and severe dry eye - To accelerate restoration of corneal surface integrity for better quality of life, visual function and comfort B. Case Presentation and Video Demonstration a) Action mechanism b) Clinical pearls 1