Sutureless cryopreserved amniotic membrane graft and wound healing after photorefractive keratectomy

Anton Vlasov, Rose K. Sia, Denise S. Ryan, Michael J. Mines, Richard Stutzman, Bruce A. Rivers, Scheffer C.G. Tseng, Kraig S. Bower

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5 Scopus citations

Abstract

Purpose To evaluate the effect of sutureless cryopreserved amniotic membrane (Prokera) on corneal wound healing after photorefractive keratectomy (PRK). Setting Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, DC, USA. Design Prospective nonrandomized control trial. Methods Patients had PRK for myopia with or without astigmatism. A 20% ethanol solution was used to create a standard 9.0 mm epithelial defect followed by photoablation with the Allegretto Wave Eye-Q 400 Hz laser. After surgery, a high-oxygen-transmissible bandage contact lens (Acuvue Oasys) was applied on the dominant eye and cryopreserved amniotic membrane on the nondominant eye. The postoperative regimen was otherwise identical for both eyes. Postoperatively, patients were evaluated daily until complete corneal reepithelialization occurred in both eyes and then at 2 weeks and 1, 3, 6, and 12 months. Reepithelialization was assessed daily with slitlamp examination, fluorescein staining, and photography. Secondary outcome measures included adverse effects, ocular comfort, visual outcomes, and corneal haze. Results Forty patients were enrolled. The amniotic membrane graft sped corneal reepithelialization 1 day after PRK but was not better than the bandage contact lens in hastening complete reepithelialization of the cornea. Visual outcomes, corneal clarity, and optical quality of the cornea were comparable between the amniotic membrane graft eyes and bandage contact lens eyes. Conclusion Although the amniotic membrane graft was reasonably well tolerated with few significant adverse effects, the role of amniotic membrane in modulating wound healing after PRK remains speculative.

Original languageEnglish (US)
Pages (from-to)435-443
Number of pages9
JournalJournal of cataract and refractive surgery
Volume42
Issue number3
DOIs
Publication statusPublished - Mar 1 2016
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems

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