Page 20 - digital-envision05-2021

A Biological Bandage for

OCULAR SURFACE

DISEASES

Making Contact

By Shirley Ha, BSc. (Hons), OD, FCOVD
early half of all patients visiting eye clinics have a complaint that could be a sign of
aqueous-deficient and/or evaporative dry eye disease (ADE/EDE). According to the
2017 TFOS DEW II report, the prominent characteristic in this multifactorial ocular
surface disease is chronic inflammation having direct and harmful effects at the cellular
1
Nlevel (epitheliopathy) and at the nerve level (loss of corneal nerves). The consequent
mobilization of both the innate and adaptive immune cells drives dry eye disease (DED) into a
vicious circle of self-perpetuating inflammation. There is also an increased risk of DED associated
with certain medical conditions that target the immune system, such as rheumatoid arthritis,
Lupus, Sjögren’s syndrome and Graves’ disease.
Current treatment protocols (artificial be used as an adjunct to dry eye
tears, dietary supplementation, thermal strategies (punctal occlusion, autologous
massage therapy, secretagogues, intense serum, tarsorrhaphy, etc.) and systemic
pulsed light therapy, scleral contact lenses, immunotherapy.
medications to suppress or interrupt the
inflammatory cascade) are often recalcitrant Since 1995, the AM has been shown to be
in some complicated, immune-mediated effective in treating many ocular surface
DED, despite compliant use. Hence, the and other inflammatory disorders,
evolving management of these cases including, but not limited to, DED,
should also include the PROKERA®’s line infectious keratitis, corneal ulcers, chemical
of cryopreserved amniotic membranes burns, bullous keratopathy, degenerative
(CAM) from Bio-Tissue, Miami, FL, or the corneal diseases and corneal nerve
BioDOPTIX® dehydrated amniotic membrane damage from diabetes or exposure
(DAM) from Labtician Ophthalmics, keratitis. It is donated by and harvested
Oakville, ON, as a pre-emptive, rather than from consenting, healthy mothers who
last resort, therapeutic option. Both can have had C-sections to regulated tissue

18 / MAY - JUNE 2021 / www.ENVISIONMAGAZINE.ca /