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Christos Theophanous, Dianne Bach, Tova Mannis, Gloria Chiu, John A Irvine, J Martin Heur; Utility of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) Scleral Lens Therapy in the Management of Primary Dry Eye Syndrome. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):363.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the results of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lens therapy on visual acuity and function in patients with primary dry eye syndrome who failed conventional treatment.
This study was approved by the USC IRB. A retrospective chart review of patients with dry eye disease refractory to conventional therapy referred to the USC Eye Institute for PROSE scleral lens evaluation from July 2009 to May 2012 was performed. Patients with underlying systemic diseases or with anatomic or functional deficits were excluded from the study. 51 eyes of 30 patients who completed PROSE fitting were included. Best-corrected visual acuity, pre and post PROSE fitting, was measured using a Snellen chart. Visual function, pre and post PROSE fitting, was assessed using the Ocular Surface Disease Index (OSDI), a 12-item questionnaire which grades severity of ocular discomfort and vision-related function. These questionnaires were obtained via telephone by a trained interviewer not involved in patient care.
Mean visual acuity improved from 0.35 (±0.44) logMAR pre-PROSE to 0.10 (±0.22) post-PROSE (p=0.0005, n = 51). This change correlates to a Snellen improvement of ~20/45 to ~20/25. Out of the 30 patients, 28 (93%) completed a pre-treatment OSDI survey and 20 (66%) were reached for a follow-up OSDI. Mean pre-PROSE OSDI score was 63.41 (±19.65) compared to 24.03 (±27.34) post-PROSE (p < 0.00001, n = 20).
The results of this study further validate previously suggested benefits of PROSE therapy for improving visual acuity and function in patients with refractory dry eye.
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