Sutureless cryopreserved amniotic membrane graft and wound healing after photorefractive keratectomy

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• 作者：Anton Vlasov ; DO<sup> ; sup><sup>antvlasov@gmail.com" class="auth_mail" title="E-mail the corresponding authorsup>Author Vitae ; Rose K. Sia ; MD ; Denise S. Ryan ; MS ; Michael J. Mines ; MD ; Richard D. Stutzman ; MD ; Bruce A. Rivers ; MD ; Scheffer C.G. Tseng ; MD ; Kraig S. Bower ; MD
• 刊名：Journal of Cataract & Refractive Surgery
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：42
• 期：3
• 页码：435-443
• 全文大小：1343 K

文摘

To evaluate the effect of sutureless cryopreserved amniotic membrane (Prokera) on corneal wound healing after photorefractive keratectomy (PRK).

sSec_2">Setting

spara0015">Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, DC, USA.

sSec_3">Design

spara0020">Prospective nonrandomized control trial.

sSec_4">Methods

spara0025">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.

sSec_5">Results

spara0030">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.

sSec_6">Conclusion

spara0035">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.

sSec_7">Financial Disclosure

spara0040">None of the authors has a financial or proprietary interest in any material or method mentioned.