Cryopreserved Amniotic Membrane (ProKera?) Treatment of Anterior Stromal Haze Secondary to HSV Keratitis
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Abstract
Purpose: To review the efficacy of cryopreserved amniotic membrane (CAM) to reduce stromal scarring in a case of refractory anterior stromal haze related to herpes simplex keratitis (HSK). The initial treatment course of conventional topical steroid and oral antiviral was completed followed by the addition of CAM to further address scarring.
Methods: Clinical presentation of a cornea with stromal haze that was refractory to previous steroid and topical and oral anti-viral therapy were documented with anterior segment smartphone capture. Best corrected visual acuity was documented to contrast clinical observations. Use of the cryopreserved amniotic membrane (CAM) Prokera® Slim was successful in reducing both anterior stromal haze and best corrected acuity.
Conclusions: CAM treatments may provide an additional therapeutic agent in the management of anterior stroma infiltration and scarring secondary to HSK. As demonstrated in this case, patients with visually significant stromal haze that is non-responsive to topical therapy may benefit from non-surgical placement of CAM. Due to the accessibility of CAM in private clinical settings, it should be considered as a viable new option for patients who have exhausted other traditional treatments and perhaps be considered in early infectious corneal disease states.
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