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CO CARE CHRONICLES
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D E C E M B E R
Biologic Corneal
Bandage to Treat
Corneal Surface
Disease
2 01 2
K R E M E R
for treating chronic inflammatory
corneal diseases, chemical/thermal
burns, corneal erosions, infectious
keratitis, lid abnormalities, HSV and
many other surface conditions.
PROKERA should be handled aseptically prior to the removal from its
packaging and insertion into the eye.
After insertion the patient may complain of a foreign body sensation
Dr. Mark J. Abraham, Optometrist
secondary to the size of the lens. The
patient should be able to maintain an
At Kremer Eye Center we are always
adequate blink response as well as
pursuing the most advanced therapeutic interventions that can enhance, have complete ocular closure. A partial
tarsorrhaphy may be required based
expedite, and facilitate a fast and
upon the nature of the condition treatcomfortable healing process for patients. The sutureless biologic corneal ed. Even with the membrane in place
topical medications may still be adbandage, PROKERA, is one of our
ministered, particularly, if dryness is an
most current therapeutic treatments.
issue or if topical medications are rePROKERA is a Class II medical device
quired. On occasion the PROKERA
that is composed of a cryopreserved
may be soaked in an antibiotic soluamniotic membrane graft (AmnioGraft)
tion prior to its insertion.
adhered to a 16mm dual thermoplastic
The device may remain in the eye
(PMMA) symblepharon ring system.
for long periods of time to allow for
Amniotic membrane is the placental
tissue that is closest to the fetus in the sufficient wound healing. The FDA
has approved it to remain in place
womb. It has natural therapeutic actions that protect the fetus from disease for up to 30 days. Its biological advantages are only delivered within
and also facilitates its development.
The tissue used to create the PROKERA the first two weeks and if in place it
device comes from placentas that have approximately takes up to eight
weeks for the membrane to combeen donated by mothers after C-section births, and they are pre-tested for pletely dissolve. However, there are
some cases were the device may
infectious disease.
need to be replaced on a five day inProtecting inflamed and damaged epterval to avoid the accumulation of
ithelial and stromal defects with
polymorphonuclear neutrophilic cells
AminoGraft helps facilitate the healthat can result in additional scarring.
ing and re-epithelization through its
In conclusion, the sutureless biologic
biologic properties; anti-inflammacorneal bandage, PROKERA, is an
tion, anti-scarring and
excellent therapeutic option for the
anti-angiogensis. PROKERA is used
E Y E
C E N T E R
chronic corneal inflammatory defects
that are non-resolving with the more
conventional bandage contact lenses
and topical medications. As a referring physician it is important to
know that it is covered by Medicare
(CPT code, 65778). Ideally, we would
prefer to first evaluate these patients
to identify their candidacy for amniotic membrane therapy and to have
adequate time order the materials.
Tseng M.D., Ph.D. , Scheffer C.G. The Ocular Surface
Research & Education Foundation Presents: Sutureless
Cryopreservered Amnion Grafts: ProKera™. Volume 1,
Number2
http;//www.biotissue.com/Patients/patients-prokera.aspx. Patients
Guide to PROKERA®
Pachigolla G, Prasher P, Di Pasculae MA, McCulley JP, McHenry
JG, Mootha VV. Department of Ophthmology, University of
Texas Southwester Medical Center, Dallas, USA. Evaluation of
the role of ProKera in the Management of ocular surface and
orbital disorders. Eye Contact Lens. 2009 Jul;35(4):172-5.
doi:10.1097/ICL.0b013e3181a66a12.
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