Shafer Brian, Fuerst Nicole M, Massaro-Giordano Mina, Palladino Vincent, Givnish Taylor, Macchi Ilaria, Sulewski Michael E, Orlin Stephen E, Bunya Vatinee Y
Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia.
Digit J Ophthalmol. 2019 Jun 8;25(2):21-25. doi: 10.5693/djo.01.2019.02.005. eCollection 2019.
To determine whether signs and symptoms of ocular surface disease improve after placement of a self-retained, cryopreserved amniotic membrane (CAM) in patients with Sjögren syndrome (SS).
The medical records of SS patients who received a self-retained CAM implant (Prokera or Prokera Slim; TissueTech Inc, Doral, FL) for the treatment of ocular surface disease between August 2012 and August 2016 at a single, large academic institution were reviewed retrospectively. Visual acuity, results of slit-lamp examination of the cornea and conjunctiva, and dry eye symptoms, were evaluated before and after CAM insertion.
A total of 6 eyes of 6 patients (all female; mean age, 62.5 ± 13.0 years [range, 49-86 years]) were included. All patients were on topical medications at the time of the study and had signs of ocular surface dryness. There were reductions in corneal and/or conjunctival staining in 5 eyes (83%) after the CAM dissolved. All patients who completed therapy (5/5) experienced a relapse in their signs and symptoms within 1 month of removal of the CAM, with an average time to relapse of 24.6 days. Mean follow-up time was 54.5 days. Foreign body sensation and blurred vision were the most common complaints associated with the CAM implant.
In this small case series, self-retained CAM implantation was found to be beneficial in SS patients with ocular surface disease that is refractory to standard therapies; however, we found that the effects were temporary. Future larger studies are needed to confirm these benefits.
确定在干燥综合征(SS)患者中植入自固定、冷冻保存羊膜(CAM)后眼表疾病的体征和症状是否改善。
回顾性分析2012年8月至2016年8月在一家大型学术机构接受自固定CAM植入物(Prokera或Prokera Slim;TissueTech公司,多拉尔,佛罗里达州)治疗眼表疾病的SS患者的病历。在植入CAM前后评估视力、角膜和结膜的裂隙灯检查结果以及干眼症状。
共纳入6例患者的6只眼(均为女性;平均年龄62.5±13.0岁[范围49 - 86岁])。所有患者在研究时均使用局部药物,并有眼表干燥体征。CAM溶解后,5只眼(83%)的角膜和/或结膜染色减轻。所有完成治疗的患者(5/5)在取出CAM后1个月内体征和症状复发,平均复发时间为24.6天。平均随访时间为54.5天。异物感和视力模糊是与CAM植入相关的最常见主诉。
在这个小病例系列中,发现自固定CAM植入对标准治疗难治的SS眼表疾病患者有益;然而,我们发现效果是暂时的。未来需要更大规模的研究来证实这些益处。