AMNIOTIC MEMBRANE THERAPY TRIAL IN SEVERE DRY EYE SYNDROME

Melnick Auditorium

Introduction. Dry eye syndrome is a common condition encountered in optometric practice. It is important to consider all treatment options in order to provide relief for patients. Case presentation. A 28 year old white male presented with complaints of blur with spectacles. Visual acuity was better, and more consistent, wearing soft hydrogel contact lenses. At several visits, visual acuity varied from 20/25 to 20/100. Corneal staining was present superiorly in a whorl-like pattern. Neovascularization of approximately 2 mm was noted superiorly in both eyes. Findings were consistent with severe dry eye syndrome, with a possible contributory limbal stem cell deficiency. Treatment with topical steroid, cyclosporine-A, and artificial tears offered limited relief. A monocular trial with an amniotic membrane (Prokera Slim®, BioTisue) was initiated OD with limited initial success. The patient was next recommended for scleral contact lenses. Deviation From the Expected. Severe dry eye is uncommon in younger males. The use of amniotic membranes for the treatment of dry eye is a relatively new option available for consideration. Discussion. Contact lens wear can lead to limbal stem cell deficiency. Discontinuation of contact lens wear is essential for resolution. The amniotic membrane used in this case yielded limited initial results. The membrane thinned after three days of wear and was extracted from the eye. Conclusion. It is important to consider all treatment options when managing dry eye syndrome. Amniotic membrane therapy is reported to aid in corneal healing. Scleral contact lens use may prevent recurrence of limbal stem cell deficiency by avoiding contact with the limbus. Grants. none