{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:14:16Z","timestamp":1790007256429,"version":"4.0.1"},"reference-count":25,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital, Taiwan","doi-asserted-by":"publisher","award":["V112-C-054"],"award-info":[{"award-number":["V112-C-054"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Amniotic membrane (AM) has anti-inflammation, anti-fibrotic, and regenerative effects. Sutureless cryopreserved AM transplantation, ProKera\u00ae (Bio-Tissue, Inc., Miami, FL, USA), is easily applied by ophthalmologists in the treatment of ocular surface diseases. This retrospective study included patients with ocular surface diseases who received ProKera\u00ae between January 2022 and May 2023. Six patients (9 eyes) with a mean age of 56.8 \u00b1 20.8 years old (range 25\u201374) and a mean follow-up period of 7.8 \u00b1 4.1 months (range 1\u201312) were included, including 2 of recurrent conjunctival tumors with limbal and corneal involvement (cases 1\u20132), 1 of pterygium with marked astigmatism (case 3) and 3 of Stevens\u2013Johnson syndrome (SJS, cases 4\u20136). ProKera\u00ae was inserted after the lesion excision and deep keratectomy in cases 1\u20133, and no recurrence or corneal complication was noted. Cases 4\u20135 were discharged from the intensive care unit and presented with severe chronic SJS. Most ocular manifestations improved significantly after symblepharon release and ProKera\u00ae insertion, except for corneal conjunctivalization in 1 eye (case 5). Case 6 involved early ProKera\u00ae use at the bedside during acute SJS, resulting in complete resolution. We concluded that the adjunctive application of ProKera\u00ae can be effective for ocular surface reconstruction and provides options to intervene earlier for outpatients or patients unstable for invasive surgical intervention.<\/jats:p>","DOI":"10.3390\/jcm12196222","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T03:49:14Z","timestamp":1695786554000},"page":"6222","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Self-Retained, Sutureless Amniotic Membrane Transplantation for the Management of Ocular Surface Diseases"],"prefix":"10.3390","volume":"12","author":[{"given":"Hsun-I","family":"Chiu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 112, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4411-3387","authenticated-orcid":false,"given":"Chieh-Chih","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 112, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1001\/archopht.1940.00860130586006","article-title":"Plastic Repair of Conjunctival Defects with Fetal Membranes","volume":"23","year":"1940","journal-title":"Arch. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Lacorzana, J., Campos, A., Brocal-S\u00e1nchez, M., Mar\u00edn-Nieto, J., Dur\u00e1n-Carrasco, O., Fern\u00e1ndez-N\u00fa\u00f1ez, E.C., L\u00f3pez-Jim\u00e9nez, A., Gonz\u00e1lez-Guti\u00e9rrez, J.L., Petsoglou, C., and Serrano, J.L.G. (2021). Visual Acuity and Number of Amniotic Membrane Layers as Indicators of Efficacy in Amniotic Membrane Transplantation for Corneal Ulcers: A Multicenter Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153234"},{"key":"ref_3","first-page":"243","article-title":"Amniotic membrane transplantation in the human eye","volume":"108","author":"Meller","year":"2011","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1076\/0271-3683(200003)2031-9FT173","article-title":"Growth factor mRNA and protein in preserved human amniotic membrane","volume":"20","author":"Koizumi","year":"2000","journal-title":"Curr. Eye Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1136\/bjo.85.4.444","article-title":"Suppression of interleukin 1alpha and interleukin 1beta in human limbal epithelial cells cultured on the amniotic membrane stromal matrix","volume":"85","author":"Solomon","year":"2001","journal-title":"Br. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1002\/(SICI)1097-4652(199906)179:3<325::AID-JCP10>3.0.CO;2-X","article-title":"Suppression of transforming growth factor-beta isoforms, TGF-? receptor type II, and myofibroblast differentiation in cultured human corneal and limbal fibroblasts by amniotic membrane matrix","volume":"179","author":"Tseng","year":"1999","journal-title":"J. Cell. Physiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s004170050012","article-title":"Cryopreserved human amniotic membrane for ocular surface reconstruction","volume":"238","author":"Kruse","year":"2000","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1166\/jbt.2014.1180","article-title":"Structural and Biological Comparison of Cryopreserved and Fresh Amniotic Membrane Tissues","volume":"4","author":"Tan","year":"2014","journal-title":"J. Biomater. Tissue Eng."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s00417-010-1499-2","article-title":"Fibrin-glue assisted multilayered amniotic membrane transplantation in surgical management of pediatric corneal limbal dermoid: A novel approach","volume":"249","author":"Pirouzian","year":"2011","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"114","DOI":"10.3928\/01913913-20110823-01","article-title":"Surgical management of pediatric limbal dermoids with sutureless amniotic membrane transplantation and augmentation","volume":"49","author":"Pirouzian","year":"2012","journal-title":"J. Pediatr. Ophthalmol. Strabismus."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"552","DOI":"10.5301\/EJO.2010.6192","article-title":"Ocular surface reconstruction using amniotic membrane following excision of conjunctival and limbal tumors","volume":"21","author":"Asoklis","year":"2011","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"242","DOI":"10.5935\/0004-2749.20170059","article-title":"Surgical amniotic membrane transplantation after conjunctival and limbal tumor excision","volume":"80","author":"Goktas","year":"2017","journal-title":"Arq. Bras. Oftalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.jcrs.2005.07.044","article-title":"Amniotic membrane as a biologic pressure patch for treating epithelial ingrowth under a damaged laser in situ keratomileusis flap","volume":"32","author":"Lee","year":"2006","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kwon, K.Y., Ji, Y.W., Lee, J., and Kim, E.K. (2016). Inhibition of recurrence of epithelial ingrowth with an amniotic membrane pressure patch to a laser in situ keratomileusis flap with a central stellate laceration: A case report. BMC Ophthalmol., 16.","DOI":"10.1186\/s12886-016-0291-4"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/ICL.0b013e31823729fc","article-title":"Removal of epithelial ingrowth via central perforating wound tract 6 years post LASIK","volume":"38","author":"Meskin","year":"2012","journal-title":"Eye Contact Lens."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1136\/bjo.84.9.973","article-title":"Amniotic membrane graft for primary pterygium: Comparison with conjunctival autograft and topical mitomycin C treatment","volume":"84","author":"Ma","year":"2000","journal-title":"Br. J. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1136\/bjophthalmol-2018-312133","article-title":"Microbiology and biofilm of corneal sutures","volume":"102","author":"Adler","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1097\/ICO.0b013e31823d02a8","article-title":"Indications and outcomes of amniotic membrane transplantation in the management of acute stevens-johnson syndrome and toxic epidermal necrolysis: A case-control study","volume":"31","author":"Hsu","year":"2012","journal-title":"Cornea"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.jtos.2020.03.004","article-title":"Long-term outcomes of amniotic membrane treatment in acute Stevens-Johnson syndrome\/toxic epidermal necrolysis","volume":"18","author":"Shanbhag","year":"2020","journal-title":"Ocul. Surf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1016\/j.ophtha.2016.04.041","article-title":"New Grading System and Treatment Guidelines for the Acute Ocular Manifestations of Stevens-Johnson Syndrome","volume":"123","author":"Gregory","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.ophtha.2015.10.027","article-title":"Adjuvant Role of Amniotic Membrane Transplantation in Acute Ocular Stevens-Johnson Syndrome: A Randomized Control Trial","volume":"123","author":"Sharma","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"132","DOI":"10.4103\/tjo.tjo_16_21","article-title":"Update on the application of amniotic membrane in immune-related ocular surface diseases","volume":"11","author":"Chen","year":"2021","journal-title":"Taiwan J. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"178","DOI":"10.3109\/08820538.2015.1114841","article-title":"Chronic Ocular Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: The Role of Systemic Immunomodulatory Therapy","volume":"31","author":"Chang","year":"2016","journal-title":"Semin. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1097\/ICU.0000000000000312","article-title":"Ocular manifestations of Stevens-Johnson syndrome and their management","volume":"27","author":"Saeed","year":"2016","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1097\/ICO.0000000000002852","article-title":"Comparing ProKera With Amniotic Membrane Transplantation: Indications, Outcomes, and Costs","volume":"41","author":"Zhou","year":"2022","journal-title":"Cornea"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6222\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:59:14Z","timestamp":1760129954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,27]]},"references-count":25,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12196222"],"URL":"https:\/\/doi.org\/10.3390\/jcm12196222","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,27]]}}}