Patient Age 93 Improves to 20/50 from 20/800 with GVR Scleral Lens

Below is a photo of me, our student extern Jennifer Vicente and our patient Gonzalo, age 93, who visited our practice from Lima, Peru. In 2014, Gonzalo's right eye suffered a retinal detachment. Following the retinal repair surgery, a corneal infection and inflammation took place in this eye which required corneal transplant surgery. Following the corneal transplant surgery, a severe defect in the outer layer of the transplanted cornea occurred which never healed. Gonzalo traveled to Miami to have us fit his right eye with a scleral lens. Upon seeing this defect we decided to use stem cell technology to speed the healing process before attempting to fit this eye with a scleral lens.

4 days ago, a therapeutic device known as the Prokera lens was placed on Gonzalo's right eye and remained on this eye without removal until this afternoon. This device is made from amniotic tissue which is the tissue closest to the baby throughout development in the womb. In addition to helping the baby develop, this tissue has healing properties that aid in ocular surface repair with less pain and scarring and less inflammation. The photos below were taken of Gonzalo's right eye when he first visited us 4 days ago and also today when the Prokera Amniotic Membrane was removed. All of the ocular photos seen here are of the right eye.

In the first 2 photos can be seen the large, deep, triangular defect. Fluorescein dye along with a special filter was used as a visual aid to better view the cornea in greater detail. The

2nd set of photos were taken today immediately after the Prokera lens was removed. The large epithelial defect which was present for many months is completely healed. To write that we were surprised would be a gross understatement.

4 days ago, the visual acuity in Gonzalo's right eye was less than 20/800. This afternoon we went through with a scleral lens fitting. With the scleral lens Gonzalo will be able to achieve 20/50 vision. Gonzalo and his family who traveled from Lima to visit us were extremely happy with the rapid healing of his right eye and with his greatly improved vision.

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