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CO CARE CHRONICLES - 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. Need a Talented, Local Glaucoma Specialist? Jesse Richman M.D., a fellowshiptrained cataract and glaucoma specialist, is now seeing new patients in our Wilmington center! Call 302-657-0386 to schedule an appointment for your patients. www.KremerEyeCenter.com CONTACT YOUR PRC FOR: CE events, marketing materials, and growing your LASIK and medical practice! YOUR PRC CAN HELP ANSWER ANY OF YOUR CO-MANAGEMENT QUESTIONS. King of Prussia, PA Judi Greenwood Nicole Chiodo 610-491-2104 P Cherry Hill, NJ 610-585-7593 E N N S Y L V A N I A Wilmington, DE Suzanne McCullough 856-340-0347 | N E W J E R S E Y Christine Nunez 760-275-1858 | D E L A W A R E