This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Eye Injuries/ Ocular Trauma  • Surgery  • Burns  • Prognosis/ Outcomes  • Emergency Medicine  • Alert me on articles by topic  Social Bookmarking   What's this?

Ahmad Kheirkhah, MD; Daniel A. Johnson, MD; Deval R. Paranjpe, MD; V.K. Raju, MD, FRCS; Victoria Casas, MD; Scheffer C. G. Tseng, MD, PhD

Arch Ophthalmol. 2008;126(8):1059-1066.

Objective  To evaluate the clinical outcome of a new sutureless approach for a temporary amniotic membrane patch (ProKera; Bio-Tissue, Inc, Miami, Florida) in eyes with acute burns.

Methods  Retrospective review of 5 eyes of 5 patients with grades I to III acute alkaline burns, receiving ProKera insertion within 8 days of injury.

Results  These eyes had either total (2 cases) or extensive (60%-75%, 3 cases) corneal epithelial defects with limbal (120°-360°) and conjunctival (30%-60%) epithelial defects. ProKera was inserted within a mean (SD) of 3.7 (3.1) days after burn and repeated 1 to 3 times for 3 cases. Conjunctival defects reepithelialized in 8.2 (5) days (range, 5-17 days), while limbal and corneal defects healed in 13.6 (8.3) days (range, 5-25 days). The latter was completed with circumferential closure of limbal defects followed by centripetal healing of corneal defects. In 3 eyes, early peripheral corneal neovascularization was followed by marked regression on completion of healing. During 16.8 (10.8) months of follow-up, all eyes retained a stable surface with improved corneal clarity, and without limbal deficiency or symblepharon.

Conclusion  This sutureless application of an amniotic membrane patch allows for early delivery of its biologic actions, which may help preserve remaining limbal stem cells for rapid expansion and prevent late cicatricial complications in eyes with mild and moderate acute alkaline burns.

Author Affiliations: Ocular Surface Center (Drs Kheirkhah, Raju, Casas, and Tseng), and Ocular Surface Research and Education Foundation, Miami, Florida (Drs Kheirkhah, Raju, and Tseng); Department of Ophthalmology, University of Texas Health Science Center at San Antonio (Dr Johnson); and Department of Ophthalmology, Allegheny General Hospital, Pittsburgh, Pennsylvania (Dr Paranjpe).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?