New Prokera Clear Amniotic Membrane Contact Lens

[PhoenixEyes]

Recently Bio-Tissue Inc. (founded by Dr. Tseng I believe) added a new option to the Prokera product line.

The original options included the Prokera Slim, Prokera and Prokera Plus. As far as I know each one represents a different thickness of membrane with the plus being double-layered. You can see a list of conditions each one is indicated for on this page.

http://www.biotissue.com/products/pr...dications.aspx

One drawback to the contact lens is that the amniotic membrane is not transparent and so you cannot see through the lens during the treatment duration. So Bio-Tissue have come out with a new option, Prokera Clear. It allows the pupil to see out of the lens while the rest of the cornea is covered. This allows people to have the Prokera in and still work or do other stuff. Reading Phillips55's helpful feedback on their experience with Prokera one of the things they mentioned was the inconvenience of not being able to see through the lens, so this may now be an option for people who were put off by that factor.

The new Prokera Clear is not yet on the list of conditions each lens is indicated for, though a news article states:

Prokera Clear® is ideal for ambulatory, chronic ocular surface disease, corneal-involved dry eye patients, and post Lasik/PRK patients.

http://www.prweb.com/releases/2016/09/prweb13713401.htm

I contacted Bio-Tissue Inc. and they stated that the new Prokera Clear is equivalent to the Prokera Slim as far as conditions it is indicated for, that includes "common dry eye and recurrent corneal erosions" plus more according to the Bio-Tissue page. For severe and rare conditions like Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis the double membrane layer of the Prokera Plus is still reccomended and the "Prokera Clear" platform is not compatible with it.

Further news articles relating to Prokera Clear below:

Bio-Tissue® Expands PROKERA® Product Line with PROKERA® Clear

How to Maintain Patient Vision During Treatment for Ocular Surface Diseases

Bio-Tissue introduces clear bandage lens

[OcchiSecchi]

It is great and promising to see such development. It is not clear to me if PROKERA is a resolutive option, or it just reduce symptoms for a posts of time.

I didn't hear about cases that have been solved with PROKERA, or I just did not find any.

And, anybody has idea about whether the amniotic membrane eye drops are a potentially better solution?

[PhoenixEyes]

It is great and promising to see such development. It is not clear to me if PROKERA is a resolutive option, or it just reduce symptoms for a posts of time.

I think it depends on the underlying cause of the dry eye. Some on the forum have contacted the developer of Prokera, Dr. Tseng, and got some replies, including one which specifies "remission" if the underlying causes are complex. However that period of remission can be anywhere from a few months to a few years according to some, I know Phillips55 say they still feel the benefits though the last time they had Prokera was in 2014. It might be worth still carrying on with some dry eye maintenance like warm compresses etc.

Yes, ProKera can help dry eye patients in several ways. I have used it successfully for them. In short, its potent anti-inflammatory action can surpass steroid and Restasis and more importantly circumvent the potential side effect known to both of them. The membrane also contains abundant nerve growth factor that is known to promote innervations which may help correct the ocular surface deficit caused by dry eye and inflammation so that the neuronal reflex can be improved. The hydration of the membrane instantly helps maintain the preocular tear film stability. For those eyes where the eyelid blinking is incomplete, it also prevents exposure-induced dryness. Once improved, the patient will normally have a “prolonged” period of remission. Because the underlying causes of dry eye are multiple and may not be fully corrected, dry eye can return later on. Nonetheless, the treatment can be repeated.

From this post

ProKera can be used for managing dry eye that has been difficult to treat this far. At this moment, I have used it for treating different types of dry eye including aqueous tear deficiency, inflammatory, and exposure, of which some did have meibomian gland dysfunction. Yes, it is covered by most insurances including Medicare.

From this post

I didn't hear about cases that have been solved with PROKERA, or I just did not find any.

Here's some success stories from people who have tried Prokera:

Phillips55: http://www.dryeyezone.com/talk/forum...done-yesterday

Amber2: http://www.dryeyezone.com/talk/forum...kera-procedure

TARYN: http://www.dryeyezone.com/talk/forum...944#post124944

In the news: http://www.dryeyezone.com/talk/forum...ssue-available

Donna with Recurrent Corneal Erosions: https://www.youtube.com/watch?v=KV2Mqkfg9Dw

Pat with Severe Dry Eye: https://www.youtube.com/watch?v=XQwFy1I1vbc

Note: Not everyone has had success with it, it's certainly not a panacea, like every treatment.

And, anybody has idea about whether the amniotic membrane eye drops are a potentially better solution?

I think that eye drops would certainly be more tolerable since the hard contact lens that is required to deliver the Prokera membrane isn't ideal for some. There's a video posted this month showing insertion and removal of Prokera at an exhibition booth of all places! The doctor says that after the anesthetic wears off, depending on how close the lens sits to the limbus, the patient will either not feel the Prokera at all or feel discomfort as if something is in their eye.

http://www.healio.com/optometry/corn...ndly-procedure

There are some "amniotic fluid" eye drops that some have had success with like RegenerEyes (Florida, US) and OptiSerum (Africa).

I think perhaps only Dr. Emiliano Ghinelli's HAMT-EU / AMX drops go the extra mile to retain as much of the original structure of the membrane by freeze drying with the “Prime 21 lyophilization method and then using a planetary mill to precisely separate it into small units, which he holds a patent for. To that end it was certified by the Italian Ministry of Health as a "transplant" much like Prokera and amniotic grafts are, and can show benefits as late as 4 years >source page 13<.

However that also makes it more difficult to export/import since it involves human tissue, right now it's only approved in Italy and no sign of acknowledgment elsewhere. I asked Dr. Emiliano Ghinelli if it would be possible for an ophthalmologist to order it to the UK or for a patient to carry it back on the plane like with PRP serum from Spain, they said it wouldn't due to the tighter regulations on human tissue, so at this time it seems it's only available by taking an extended holiday to Italy and accessing it via private healthcare.

I have another thread for the eye drops: http://www.dryeyezone.com/talk/forum...ps-hamt-eu-amx

[OcchiSecchi]

Wonderful and detailed explanation PhoenixEyes. I have learned a lot !

Since my dry eye discomfort has been triggered by my FemtoLasik 1 year and half ago (this is my story: http://www.dryeyezone.com/talk/forum...rs-after-lasik), I am exploring Prokera, HAMT-EU, or Serum drops given that I understand that their nerve regenerative capacity might help (hopefully) to heal my cornea to baseline. I hope that I am still on time for this..although I should have picked one of these options on the day after the surgery..instead than wasting time with artificial drops. Thank you for sharing any thoughts on this matter.

[PhoenixEyes]

I hope that I am still on time for this..although I should have picked one of these options on the day after the surgery..instead than wasting time with artificial drops.

Phillips55 only tried Prokera 3 years after LASIK, but they still say it helped them. You could try private messaging them if you have any questions about Prokera

I also found a video by one of the first developers of amniotic membrane therapy (AMT) for eyes, and there was one story where a 4 year old boy suffered severe corneal damage due to Stevens-Johnson Syndrome that left him blind, 13 years later he got AMT and started reading a book!
https://www.youtube.com/watch?v=CQAA...youtu.be&t=299

I hope you find the same success with one of the three treatments.

I do hope HAMT-EU becomes more accessible since that may be a more tolerable form of AMT than the lens, I'd really like to try it.

Autologous serum is also well worth a shot. Actually judging by a trial here in the UK, you may even be able to try it at home at first with a diabetic lancet and finger wipe, check slide 7 ~ 9 here:
http://www.researchgate.net/profile/...f20bfdad4ffe35

http://www.dryeyezone.com/talk/forum...tologous-blood