New Prokera Website for Dry Eye

[hankm9]

http://www.prokerainfo.com/clinical/...e-keratopathy/

[spmcc]

I asked my cornea specialist about Prokera. He said we already have good anti-inflammatories such as topical cyclosporine and steroids.

Another doctor (an oculoplastic ophthalmologist) said he'd look into Prokera for me and get back. I'll post what I hear.

[hankm9]

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[hirentherock]

I have extreme photophobia+pain and low vision from sjs.
I asked the head of biggest eye clinic in India abt prokera.
He said its for acute cases and wont be applicable to me.

i wonder why its not suggested for moderate to sever cases and only for the severe cases?
I do feel much much relieved with fml in terms of pain but cannot continue it just for the symptomatic relief due to its side effects.

[DCRdryeye]

Prokera is an amniotic membrane that's applied using a ring to a portion of the ocular surface, or sutured to the eyelids for better coverage. However, it seems it doesn't penetrate the meibomian glands on the eyelids or seap into the duct where the tears are secreted from the lacrimal glands. Therefore my hypothesis is that amniotic membrane would work better applied as a fluid such as AMX drops. We all know when a "drop" is applied to the eye it saturates ALL of the ocular surface (unlike Prokera), it saturates the eyelids thus penetrating the meibomian glands and possibly penetrates into the hole where tears are secreted from the lacrimal glands...and possibly reaches the lacrimal glands and exudes it's anti-inflammatory and rejuvenation properties.

I could be wrong, but what if I'm right? I'd be willing to catch a flight to Italy and find out.

[hankm9]

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[kandykane1544]

This sounds awesome. How expensive does a procedure like this cost? Yeah, I was prescribed restasis by my eye doctor, and then I went to another one and he said prescribing me restasis was a dumb thing to do because my problem is MGD, not lacrimal gland function. That being said, people with MGD should also be candidates for this because we also have an overproduction of inflammatory cells on the surface of our eyes. Very cool though.

[littlemermaid]

I asked the head of biggest eye clinic in India abt prokera. He said its for acute cases and wont be applicable to me.

I'm finding that we know about new world treatments before the local country docs. Then, because the treatments are not tried in our country yet, the docs say they are not for us. Then, about 2 years later, they say 'you can have ...x...' as if they are doing us a massive favour with innovation and we should be grateful.

Maybe your doc thinks the amniotic membrane patch always has to be sutured on and is therefore just for acute eye surface damage. Do you think he's heard about the Prokera ring and AM eyedrops? They find it difficult to admit they don't know current medical information. I do respect a doc who does admit what they don't know and refers on.

As Spmcc, it has to be better for recurrent erosions and damage than the tons of steroid or cyclosporine we have to use.

[hankm9]

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[bakunin]

I'm finding that we know about new world treatments before the local country docs. Then, because the treatments are not tried in our country yet, the docs say they are not for us. Then, about 2 years later, they say 'you can have ...x...' as if they are doing us a massive favour with innovation and we should be grateful.

Maybe your doc thinks the amniotic membrane patch always has to be sutured on and is therefore just for acute eye surface damage. Do you think he's heard about the Prokera ring and AM eyedrops? They find it difficult to admit they don't know current medical information. I do respect a doc who does admit what they don't know and refers on.

As Spmcc, it has to be better for recurrent erosions and damage than the tons of steroid or cyclosporine we have to use.

If where I am they think scleral lenses are not to be used for severe dry eye symptoms, I don't even imagine asking them about Prokera...

[littlemermaid]

Topical Amnion Membrane Extract for the Treatment of Corneal Persistent Epithelial Defects: Results of the European Clinical Trial - Kenneth R Kenyon MD; Emiliano Ghinelli MD
Poster 54 abstract AAO/APAO Chicago 2012

Purpose: To evaluate topical application of lyophylized extract of amnion membrane extract (AMX) for treatment of corneal persistent epithelial defects (PEDs). Methods: Following the Treviso (Italy) Tissue Bank protocol, 42 eyes of 37 patients with PEDs from 6 European eye clinics underwent open label treatment with AMX, applied every 2 hours while awake for 4 weeks or until PED healed. Results: In all eyes, no adverse reactions occurred. Symptoms improved in 40/42 eyes (95%). Conjunctival inflammation decreased in 41/42 (98%). PED healing was complete in 40/42 (95%), averaging 21 days (range: 7-28 days). Conclusion: Topically applied AMX demonstrated safety (100%) and efficacy (95%) in promoting the healing of corneal PEDs.

[sazy123]

Topical Amnion Membrane Extract for the Treatment of Corneal Persistent Epithelial Defects: Results of the European Clinical Trial - Kenneth R Kenyon MD; Emiliano Ghinelli MD
Poster 54 abstract AAO/APAO Chicago 2012

Purpose: To evaluate topical application of lyophylized extract of amnion membrane extract (AMX) for treatment of corneal persistent epithelial defects (PEDs). Methods: Following the Treviso (Italy) Tissue Bank protocol, 42 eyes of 37 patients with PEDs from 6 European eye clinics underwent open label treatment with AMX, applied every 2 hours while awake for 4 weeks or until PED healed. Results: In all eyes, no adverse reactions occurred. Symptoms improved in 40/42 eyes (95%). Conjunctival inflammation decreased in 41/42 (98%). PED healing was complete in 40/42 (95%), averaging 21 days (range: 7-28 days). Conclusion: Topically applied AMX demonstrated safety (100%) and efficacy (95%) in promoting the healing of corneal PEDs.

This is interesting. I should be moving back to England, and i might look into where i can obtain these drops....

[wagnermid]

Prokera now confirmed as a treatment for dry

Thoughts?

I found the only thing I couldn't access on the website was the "evidence" section. A single case study is the lowest form of medical evidence and would be considered by a medical practitioner as an interesting idea for further research, not a reason to change practise. So while it is a good development it is a long way from being current accepted practise.

Frustrating as that is, it is to ensure medicine is scientific and evidence based. Prokera seems to be an alternative for the traditional form of amniotic membrane transplant, which is not new. If it works for dry eye the research needs to be done by the manufacturer before it will be used.

We were in Texas on holidays recently when we heard about Prokera on this forum, but after lots of reading decided our son's Corneal specialist who is very involved in research here in Australia, was the person who would give us the best care guidance as we are sure if the research is convincing she will offer it to us if and whenit is appropriate, and I will ask about it when she returns from the AAO 2012 meeting!

[DCRdryeye]

wagnermid, is your sons corneal specialist in Australia? I am putting together a list of eye doctors worth seeing, could you possibly inbox me the doctors details please.

[Rebecca Petris]

Have to echo wagnermid here... I had a look through mentions of it on PubMed and by and large the only context I saw for it there in the published reports was as an aid in healing severe corneal damage situations eg from SJS, TEN, alkaline burns etc. Very different from treating dry eye.