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Sutureless Amniotic Membrane ProKera for Ocular Surface Disorders: Short-Term Results

Suri, Kunal M.D.; Kosker, Mustafa M.D.; Raber, Irving M. M.D.; Hammersmith, Kristin M. M.D.; Nagra, Parveen K. M.D.; Ayres, Brandon D. M.D.; Halfpenny, Colleen P. M.D.; Rapuano, Christopher J. M.D.

doi: 10.1097/ICL.0b013e3182a2f8fa

Objective: To evaluate the indications and outcomes of sutureless amniotic membrane transplant (AMT; ProKera) in the management of ocular surface disorders.

Methods: Chart review of patients who had ProKera (Bio-Tissue, Inc.) implantation for ocular surface disorders between June 2008 and May 2012 at 3 ophthalmology practices in Philadelphia, PA. The parameters evaluated included age, sex, indication for AMT, any other combined procedure, duration of retention of amniotic membrane, the effect of amniotic membrane on ocular surface healing, follow-up time, and complications.

Results: There were 35 eyes of 33 patients with a mean age of 68.2±19.5 years (range: 17–99 years). There were 25 male patients, and median follow-up was 110 days (mean: 164.6 days; range: 30–960 days). The indication for insertion of ProKera was nonhealing corneal ulcers of infective origin (group 1) in 9 eyes (25.7%), neurotrophic keratopathy (group 2) in 11 eyes (31.4%), chemical injury (group 3) in 5 eyes (14.3%), and other indications (group 4) in 10 eyes (28.6%). Complete or partial success was seen in a total of 44%, 64%, 80%, and 70% eyes in groups 1 to 4, respectively. Discomfort with the device was seen in 6 (17.1%) of 35 eyes, and recurrence of primary pathologic condition occurred in 5 (14.3%) of 35 eyes.

Conclusion: ProKera treatment is easy to use and reasonably well tolerated, with moderate success in corneal ulcers and encouraging results in acute moderate chemical injury. Recurrence of primary pathologic condition is seen particularly associated with neurotrophic keratitis and dry eye syndrome.

Supplemental Digital Content is Available in the Text.

Cornea Service, Wills Eye Institute, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA.

Address correspondence and reprint requests to Christopher J. Rapuano, M.D., Cornea Service, Wills Eye Institute, Suite 920, 840 Walnut Street, Philadelphia, PA 19107; e-mail:

C.J.R. is currently a consultant and does lectures for Bio-Tissue, but not during the study or writing of the manuscript. The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions this article on the journal's Web site (

Accepted June 29, 2013

© 2013 Contact Lens Association of Ophthalmologists, Inc.