Prokera update

[sazy123]

I would really be interested still as to whether this would help- inner eyelid inflammation (that is chronic)? Not just eye surface inflammation.

I have ALOT of visible inflammation on my inner eyelids (look like allergies but its not- had all the tests), and this is causing MGD.

If this were to help chronic inflammation by healing whatever is causing it? Ocular rosacea-maybe. Then the drops would be better because they would reach the eyelids- rather than just the surface?

What do others think about this thoery? and has there been any comment from the doctor on this?

[Tankie]

Thanks very much for the advice. I really hope this works, but like you say, even if it doesn't, it shouldn't do any harm to try.

[hankm9]

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[Pinky]

The following study seems to confirm that ProKera is low risk, with the adverse events being: epithelial defects remain, implant coming out, eye pain or headache. If a DES patient has it done by a local doctor, perhaps it could be tried in one eye first?

http://www.ncbi.nlm.nih.gov/pubmed/19474753


The mean duration of ProKera retention was 25.3 days (range, 0-125) visual acuity improved in 12 eyes (60%). Immediate adverse events included residual epithelial defects after removal (five eyes) and spontaneous extrusion of the implant (four eyes). Six patients (30%) reported eye pain or headache and four eyes (20%) had recurrence of the primary pathology.
CONCLUSIONS:
Sutureless and adhesiveless amniotic membrane transplantation is a safe and effective method to promote healing and reconstruction of the ocular surface and orbit with minimal side effects. Recurrence of the underlying primary pathology remains a concern. The advent of a newer, softer conformer ring may improve patient tolerability and limit discomfort.

[hankm9]

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[hankm9]

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[spmcc]

Everything that I read says that Prokera should be used in the ACUTE STAGE of eye trauma.

See for e.g., http://www.osref.org/media/documents...ionl_guide.pdf

[hankm9]

Yes spmcc, we have already established that. But like dr. Panzer reported, it was used in a severe dry eye patient that led to a messed up cornea and worked wonders for her dry eye & light sensitivity. We're just trying to estabish if it will help with pain, even though we haven't had a chemical burn, it could still help with re current photophobia & inflammation.

[Blinks]

While reading the DEWS report last night, I was surprised to read in Level 4 severity, amniotic membrane transplantation is listed in the recommended treatments as one of several surgical options (p174, table 4). Perhaps at the time of publication 2007, Prokera may not have been widely used.

DEWS: http://www.theocularsurface.com/userfiles/file/DEWS.pdf

The report goes on: "Therapeutic recommendations for level 4 severity disease include surgical modalities to treat or prevent sight-threatening corneal complications.Discussion of these therapies is beyond the scope of this report. "

Still interesting to note.

[spmcc]

But like dr. Panzer reported, it was used in a severe dry eye patient that led to a messed up cornea and worked wonders for her dry eye & light sensitivity. We're just trying to estabish if it will help with pain, even though we haven't had a chemical burn, it could still help with re current photophobia & inflammation.

Panzer totally backpedalled on that (via email):

The prokera was of benefit for a patient who had already benefited from my hormone drops for about six months. She also wore bandage contact lenses for many many months.
Why Prokera? Becauses her corneas just wouldn't heal any other way!
Prokera is not and should not be thought of as a cure for dry eye. It is strictly a way to get intractable corneal staining to calm down. What really fixed my patient? Hormone drops.

We have plenty of people here on DEZ who have gone to see Tseng (developer of Prokera). None of them were offered it. Why wouldn't Tseng give it to these people if it could help even a little? He should be the one showing that Prokera can work in many different situations. I wonder why he isn't doing that.

[bunnyrabbit123]

Good question!. Does anyone know what this procedure costs? I'm thinking that if insurance covers this, doctors don't necessarily want to get involved in trying to justify the expense if they can push you out the door with steroids, plugs and restasis- you're taking up time they could be using to do lasik!

[Pinky]

I have sent an email to Dr. Tseng and Biotissue to get their comments on whether ProKera is a suitable treatment for severe dry eye.

According to Dr. Panzer the lenses themselves cost $1,000.00 each and can easily rip upon installation. Sadly, this price is comparable to other DES treatments like LipiFlow and ****** probing.

I heard back from the Italian MD regarding AMX drops and will post info on the other thread.

[hankm9]

Agree bunny rabbit!

[Tankie]

I have sent an email to Dr. Tseng and Biotissue to get their comments on whether ProKera is a suitable treatment for severe dry eye.

According to Dr. Panzer the lenses themselves cost $1,000.00 each and can easily rip upon installation. Sadly, this price is comparable to other DES treatments like LipiFlow and ****** probing.

I heard back from the Italian MD regarding AMX drops and will post info on the other thread.

Could you please link me to this post because I couldn't find it. Thank you.
Also, I definitely want to be in the loop on the conversation around ProKera, so if there's any private messages going around behind the scenes, please get me in on it! =)

[Pinky]

"Could you please link me to this post because I couldn't find it. Thank you."

http://www.dryeyezone.com/talk/showt...rops-%28AMX%29