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Simon R. Bababeygy, John A. Irvine, Gloria B. Chiu; Prosthetic Replacement Of The Ocular Surface Ecosystem (PROSE) Treatment at Doheny Eye Institute. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4718.
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The PROSE device has helped improve vision and quality of life in a number of patients with a reported 86% of patients showing improvement in visual acuity and 88% of patients with improvement in visual functioning. This study aims to evaluate the effectiveness of PROSE therapy offered at The Doheny Eye Institute partner clinic, used for patients suffering from corneal surface disease refractive to other forms of therapy.
Retrospective clinical chart review of 145 consecutive patients (238 eyes) with PROSE therapy from September 2009 to November 2011 was performed. Patient charts were analyzed for best corrected visual acuities (BCVA) in treated eye at baseline and at the proper fitting visit. Number of office visits and demographics, were also recorded.
The average age was 56 years (range 19-87) with 55% females. Primary Ocular Diagnoses include Keratoconus (34.5%), Graft Versus Host Disease (15.5%), Penetrating Keratotomy (15.5%), Keratoconjunctivitis Sicca (8.62%), LASIK complication (6.90%), Sjogren’s Syndrome (6.90%), Radial Keratotomy (5.17%), Stevens Johnson Syndome (3.45%), Lagophthalmos (1.72%), and Irregular Astigmatism (1.72%).The average number of visits for fitting completion of patients was 3.54 visits (range 2-6). There was a significant difference between the patient’s BCVA at baseline and final fitting (p<0.05). The average improvement in logMAR in BCVA in corrected eye was -0.487 (5.15 lines on Snellen Chart). There was a significant difference between both the number of devices used and the reason for therapy (p<0.0001) and between number of visits and the reason for therapy (p=0.0002).
This study found that there was a significant difference between both the number of devices and the number of visits required for fitting and the primary ocular diagnosis of the patient. Our analysis reveals that more devices are required to achieve optimal fits for eyes that have greater ocular surface irregularities, such as patients with SJS, PK and post-LASIK complications. We also found that the number of follow up visits are higher for patients with SJS, PK, and keratoconus. This supports that patients with more severe ocular surface disease and irregularities may require more time for insertion and removal training.
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