Indications and Outcomes of Self-Retained Cryopreserved Amniotic Membrane at a Tertiary Care Center
Tejal M. Patel, Zeba A. SyedPurpose:
To evaluate the indications and outcomes of a self-retained cryopreserved amniotic membrane (AM) (Prokera, Bio-Tissue, Miami, FL) at a tertiary care center and identify diagnoses associated with more favorable outcomes.
Methods:
A retrospective chart review of all patients who presented to Wills Eye Hospital and underwent in-office cryopreserved AM placement between February 2015 and December 2023 was performed. Data from the presenting visit including underlying diagnosis, best-corrected visual acuity (BCVA), and corneal epithelial defect size were collected. Epithelial defect size was compared between the baseline visit, 1 week (early follow-up), and 1 month (later follow-up) after AM application. BCVA was compared between baseline and later visits.
Results:
A total of 328 patients underwent cryopreserved AM placement and mean age was 60.4 ± 18.3 years. On average, AM was in place for 19.3 ± 16.1 days (median 14 days, interquartile range 7–28 days), and patients received a mean of 1.12 ± 0.42 Prokera placements per eye. The most common indication was mechanical injury (97; 29.6%), followed closely by neurotrophic keratopathy (96; 29.3%). Compared with mechanical injury, the diagnosis of chemical burn had a higher proportion of early improvement (83.7% vs. 67.0%;
Conclusions:
Cryopreserved AM was associated with higher epithelial healing proportions among those with chemical burns, and lower epithelial closure proportions may be associated with immune-mediated melt.