TissueTech Inc, Miami, FL, USA.
Cornea. 2010 Mar;29(3):359-61. doi: 10.1097/ICO.0b013e3181acf816.
The purpose of this case report is to describe the efficacy and limitation of ProKera, a sutureless medical device containing amniotic membrane, for treating acute ocular manifestations of toxic epidermal necrolysis (TEN).
ProKera was inserted in both eyes at day 10 after onset of ocular symptoms in a 5-year-old boy suffering from acute TEN, manifesting conjunctival inflammation, large conjunctival defects, pseudomembrane formation, and total corneal epithelial defects.
At 9-month follow-up, insertion of ProKera resulted in complete reepithelialization, clear corneas, and vision of 20/20 in both eyes. However, because ProKera only covered the cornea and perilimbal conjunctiva, these 2 eyes still showed some conjunctival inflammation several months after discharge from the hospital. Eventually, 1 eye showed mild lid margin keratinization and cicatricial entropion, and both eyes showed trichiasis.
These data suggest that ProKera, when inserted during the acute stage of TEN, may be effective in healing corneal epithelial defects and preventing corneal sequelae. Because of the limited area covered, ProKera may not prevent cicatricial complications in the fornix, tarsus, and eyelid margin as effectively as sutured amniotic membrane transplantation.
本病例报告旨在描述 ProKera（一种含羊膜的无缝线医疗器械）在治疗毒性表皮坏死松解症（TEN）急性眼部表现中的疗效和局限性。
一名 5 岁男孩患有急性 TEN，出现结膜炎症、大的结膜缺损、假膜形成和全角膜上皮缺损等眼部症状，在发病后第 10 天，双眼均插入 ProKera。
在 9 个月的随访中，插入 ProKera 导致双眼完全上皮化、角膜清晰、视力达到 20/20。然而，由于 ProKera 仅覆盖角膜和缘周结膜，这 2 只眼睛在出院后几个月仍存在一些结膜炎症。最终，1 只眼睛出现轻度睑缘角蛋白化和瘢痕性内翻，双眼均出现倒睫。
这些数据表明，在 TEN 的急性阶段插入 ProKera 可能有助于治愈角膜上皮缺损并预防角膜后遗症。由于覆盖面积有限，ProKera 可能无法像缝线羊膜移植那样有效地预防穹窿、睑板和睑缘的瘢痕性并发症。
