ProKera video

[Pinky]

I just got a Google alert about this video: http://sparkfactor.com/prokera-in-office-demo/

[bunnyrabbit123]

Oh, this looks amazing! Is this the magic bullet? How would I find a practice that utilizes this treatment for dry eye?

[angyeo]

i found more videos about prokera on this youtube channel! http://www.youtube.com/user/biotissueinc

[Pinky]

J. James Thimons, OD, FAAO talks about using ProKera in the latest issue of Optometric Office February 2013

OSD LEVEL IV
Almost all treatment recommendations in level IV are surgical in nature and involve grafts, flaps, tarsorraphy, and other protective interventional procedures. A new technology that is appropriate for this level that I have had the opportunity to use several times is Bio-Tissue’s ProKera Amniotic Membrane. This system utilizes amnion that is retrieved following caesarean sections, and unlike earlier applications, does not require suturing of the tissue. ProKera uses a patented application whereby cryopreserved amniotic membrane is suspended in a ring that is placed on the cornea. It provides significant regenerative support to severely damaged ocular surfaces such as patients with chemical burns, Stevens-Johnson syndrome, and non-healing infectious keratisis, as well as severe end-stage dry eye.

[bunnyrabbit123]

God bless you for this, Pinky. I'm going to check out that article. Your timing is perfect- I had a disappointing appt yesterday with an opth. that I thought wanted to work with me. Instead, he commmented that I'm right where I was 3 mos ago. "Pretty dry" glands clogged, dry spots on cornea. He sees no improvemenmt from T- drops, so I can stop them and there's nothing else. We've done everything- come back in 6 mos. I left there feeling pretty bad. I'm really hoping that for those of us who've done "everything" and gotten minimal relief, Prokera might give a way back to having a life.

[Pinky]

http://www.youtube.com/watch?v=GjGA4AOudVg

A new video of doctors talking about their experience with ProKera. Not a lot about dry eye, but I encourage anyone who has any questions about the treatment to post them on the page. Questions seem to be answered withing 24 hours.

[bunnyrabbit123]

Thanks for posting this, Pinky,
In the comments section below video, someone asks if Prokera is a suitiable treatment for dry eye and Bio-Tissue replies by saying this is a well known treatment option among eyecare professionals- why then, is it not offered?
I mean, right now I'm really grumpy about eye drs. but it seems to me that as far as they're concerned, it's fine for me to spend my days using restasis, otc drops, gels at nite, etc. My nightstand drawer is so crammed with stuff I've been given,both rx and otc that I can't get the damn thing open. I would sell my soul to get up in the am and know that I could just go out without fear of the climate at malls/movies/home depot etc. Prokera has never been suggested as an option. So what's going on?

[patientpatrick]

So i'm rather confused, it would seem for us who are suffering from a more chronic dry eye problem, that once the prokera is removed the dry eye would return. Seems like something similar to a prose or scleral lens. I'm not expert on this, but I'm curious if any chronic dry eye sufferer has had success with prokera.

[Blinks]

It may be worth calling Bio-Tissue (the manufacturer) and asking for the names of doctors in your area who are using Prokera. Their website has a toll free number.
I asked my cornea doctor about it for use after superficial keratectomy for cornea degeneration -- not a dry eye issue -- and was turned down, but later learned it is being used by other doctors at the same eye center, though I don't know if it's used in dry eye cases. I phoned the cornea service at the eye center and inquired about its use and to see if it's covered by insurance. The answer I received is "it depends on the procedure and diagnosis".

[bunnyrabbit123]

prokera

My understanding is that the prokera remains on the eye for about a week as it's being absorbed by the eye and healing the ocular surface. They (Bio-tissue) do say that it's not a cure, after a period of time (months?, a year?) it would need to be done again but the healing properties of amniotic membrane are supposed to be quite remarkable. These videos suggest it's a wonderful treatment for dry eye. No one, to my knowledge, has been offered this as treatment . It's reserved for those with serious cornea damage or used post surgery. So my confusion is that the company seems to be saying it is used to treat dry eye and Drs. say not.

[Blinks]

Patrick, Prokera is an amniotic tissue graft, so it's not removed. The plastic ring containing the graft is removed once the graft has taken hold and has grown onto the ocular surface. So it's the ring-like "frame" which allows a non-surgical placement.

Prokera has no relationship or resemblance to PROSE or scleral lenses. PROSE and scleral lenses are removable hard contact lenses.

Prokera is a human amniotic tissue graft so it aids in the healing of the ocular surface.

I'm very interested in this treatment for corneal degeneration and secondary dry eye, foreign object sensation, feeling like sand in my eyes all the time, halos, glare, and a really special private light show at night which prevents night driving.

There's lots of information on the Biotissue site and several YouTube videos. http://www.biotissue.com/Patients/patients-prokera.aspx

[Pinky]

I encourage anyone who has questions to post directly on this page:

http://www.youtube.com/watch?v=GjGA4AOudVg

[Blinks]

PubMed has an article (2009):Evaluation of the role of ProKera in the management of ocular surface and orbital disorders.
http://www.ncbi.nlm.nih.gov/pubmed/19474753
" 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." This study included 20 eyes.

[bunnyrabbit123]

Blinks-
Yeah, night driving is a real trip! Thanks for the PubMed info. That seems like a lot of problems for a small study.

[Pinky]

The adverse events the study mentions are low risk - epithelial defects remain(i.e implant doesn't work) implant comes out, eye pain or headache.


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.