published on December 14, 2017 by
I love what I do, and one of my greatest accomplishments is knowing that I truly impacted a patient’s quality of life. This was the case with one of my patients, a 45 year-old male who works using his computer all day – he also happens to only have one eye. About two years ago, he came to see me and was extremely distraught because he could no longer see his computer without his eye watering and burning. He had moderate glaucoma and was also a steroid responder, meaning we couldn’t give him a standard steroid to help with his symptoms without compromising his glaucoma.
My first thought was that this case was perfect for cryopreserved amniotic membrane (PROKERA) however, because he only has one eye there was some concern about his vision being compromised during treatment. He was desperate for a solution, so decided to move forward with PROKERA Slim (at the time PROKERA Clear was not yet available) and he came to see me with his wife on a Friday to have it inserted. At the time he was 3 plus SPK and had 2 plus injection. His visual acuity was 20/40 minus 2. Prior to that, his visual acuity had been anywhere from 20/50 to 20/60. He was taking two glaucoma medications, RESTASIS®, artificial tears and gels, but was still very uncomfortable.
We inserted PROKERA and everything went well. I explained what to expect, and gave him my number in case he needed to reach me over the weekend. Unfortunately, the following morning his vision was way too blurry for him to stand. His vision was about 20/400, so it was very uncomfortable for him. As this is his only eye, he became very anxious and wanted to have the lens removed. Another doctor who was in the office at the time saw the patient and removed PROKERA after only 16 hours.
But what happened next was truly amazing. There was only trace SPK, injection was about grade 1, and the patient’s vision had improved to 20/25, at least two lines better. And that was only after 16 hours. The patient was beyond thrilled with the results.
A few months later, the patient’s vision decreased again so he returned. We had since started also using PROKERA Clear, which in addition to healing the cornea helps maintain visual acuity during treatment. We inserted this in his eye, and he was pleased he could now wear it the entire weekend. After removal, the patient’s vision again improved to 20/25. After that, he didn’t need to come back for nine months, at which time we repeated the treatment. That was six months ago, so I’m assuming in another three months he will have another PROKERA inserted.
This case was very significant because I saw the impact PROKERA made in just 16 hours. It has no side effects, and unlike steroids doesn’t compromise other diseases, which in this case was glaucoma. It was very meaningful to this patient to treat something that bothered him on a daily basis for years, resulting in his vision returning to 20/25. He talks all the time about how PROKERA changed his life. As a practitioner, it is so meaningful to make such an impact and have a patient say, “I will forever be grateful that you had PROKERA and were willing to try it on me.”
Susan B. Janik, OD, practices at Solinsky EyeCare in West Hartford, CT where she is active in its Dry Eye Center. She is licensed in Advanced Optometric Care and is certified in Corneal Reshaping Therapy technology. Dr. Janik is an active member of the American Optometric Association including its Contact Lens and Cornea section and the Connecticut Association of Optometrists.