Navigating Advanced Dry Eye Treatments: Prokera vs. Neox Flo
For patients living with the persistent discomfort of moderate to severe dry eye disease, traditional therapies like artificial tears and prescription eye drops may not provide adequate relief. When the ocular surface is compromised, your eye care professional may recommend more advanced treatments to promote healing and reduce inflammation. Among these innovative options are Prokera and Neox Flo, two therapies that utilize the regenerative properties of amniotic tissue.
This article will delve into what these treatments are, how they work, and the key differences to help you have a more informed discussion with your doctor about which approach might be more appropriate for your specific condition.
The Healing Power of Amniotic Tissue
Both Prokera and Neox Flo are derived from amniotic membrane, a part of the placenta that nourishes and protects a developing baby. This remarkable biological material is rich in growth factors and has natural anti-inflammatory and anti-scarring properties. When applied to the eye, it can help soothe the surface, reduce inflammation, and promote the healing of damaged corneal tissue, which is often a root cause of severe dry eye symptoms.
The amniotic tissue used in these treatments is donated by consenting mothers after a scheduled Cesarean section and is carefully screened and processed to ensure safety and efficacy.
Prokera: A Healing Shield for Your Eye
What it is: Prokera is a medical device that resembles a large, clear contact lens. It consists of a piece of cryopreserved (frozen to preserve its natural properties) amniotic membrane stretched and held in place by a small, flexible polycarbonate ring.
How it works: Your eye doctor will insert the Prokera device onto your eye in the office, much like placing a contact lens. Once in place, the Prokera ring rests on the white of the eye (the sclera), and the amniotic membrane continuously bathes the cornea in its healing and anti-inflammatory agents. It also acts as a physical barrier, or a "biologic corneal bandage," protecting the corneal surface from the friction of blinking and further irritation.
The Patient Experience: The Prokera device is typically left in the eye for several days, during which the amniotic membrane gradually dissolves and imparts its therapeutic benefits. Patients often experience significant relief from symptoms like pain, light sensitivity, and blurry vision. However, because it is a solid ring, some patients may experience initial discomfort or a foreign body sensation. Your vision may also be blurry while the device is in place.
Neox Flo: A Liquid Approach to Regeneration
What it is: Neox Flo is a cryopreserved amniotic membrane and umbilical cord particulate. Instead of a solid ring, it comes as a sterile powder that is mixed with saline to create a suspension.
How it works: This liquid solution is then applied directly to the surface of the eye by your eye doctor. The microscopic particles of amniotic tissue in Neox Flo adhere to the damaged areas of the cornea and conjunctiva, delivering the same powerful healing and anti-inflammatory properties as the solid membrane in Prokera.
The Patient Experience: The application of Neox Flo is a quick, in-office procedure. As it is a liquid, patients generally do not experience the same level of foreign body sensation that can be associated with the Prokera ring. The therapeutic effects are delivered as the particles remain on the ocular surface, promoting healing over time.
Head-to-Head: Prokera vs. Neox Flo
| Feature | Prokera | Neox Flo |
|---|---|---|
| Form | Solid, ring-based device with a sheet of amniotic membrane | Liquid suspension of amniotic membrane particles |
| Application | Inserted onto the eye like a large contact lens | Applied as eye drops or a wash |
| Sensation | May cause a foreign body sensation due to the ring | Generally more comfortable upon application |
| Duration of Wear | Worn continuously for several days until the membrane dissolves | Particles remain on the eye's surface to provide therapeutic benefit |
| Vision | Vision is typically blurry while the device is in place | May cause some initial blurriness that clears more quickly |
When Might One Be More Appropriate Than the Other?
The choice between Prokera and Neox Flo will ultimately be a decision you and your eye doctor make based on the specifics of your condition. Here are some scenarios where one might be favored over the other:
Prokera may be more appropriate for:
Localized, severe corneal damage: The constant presence of the amniotic membrane over a specific area of damage, such as a corneal ulcer or a persistent epithelial defect, can be highly beneficial.
Need for a protective barrier: In cases where the friction from the eyelids is a significant contributor to the problem, the bandage-like effect of Prokera can provide crucial protection.
Patients who can tolerate the initial sensation: For those who are not overly sensitive to the feeling of a foreign object in the eye, Prokera is a powerful, all-in-one healing solution.
Neox Flo may be a better choice for:
Diffuse inflammation and surface damage: When the irritation and damage are spread across the entire surface of the cornea and conjunctiva, a liquid application that can coat the whole eye may be advantageous.
Patients with low tolerance for discomfort: For individuals who are very sensitive or have had difficulty with scleral lenses or other devices, the liquid form of Neox Flo is likely to be more comfortable.
Cases where maintaining clearer vision during treatment is important: While there may be some initial blurriness, it often subsides more quickly than with the Prokera device.
An Important Conversation with Your Doctor
Both Prokera and Neox Flo represent significant advancements in the treatment of severe dry eye and other ocular surface diseases. They offer a way to move beyond just managing symptoms to actively healing the underlying damage.
If you are struggling with persistent dry eye despite trying other treatments, a discussion with your ophthalmologist or optometrist about these amniotic membrane therapies is a worthwhile next step. By understanding your specific signs and symptoms, the health of your corneal surface, and your personal comfort level, your doctor can help you determine if Prokera or Neox Flo is the right choice to bring you lasting relief and improved eye health.