Purchase this article with an account.
D. S. Jacobs, T. Hussoin, P. Rosenthal; Rehabilitation of Exposure Keratopathy With a Scleral Lens Prosthetic Device. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4782.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report on the rehabilitation of patients with exposure keratopathy with the Boston Ocular Surface Prosthesis (BOSP).
A clinical database of patients fitted with the BOSP, a fluid-ventilated gas-permeable scleral lens, from January 1996 - July 2008 was sorted by diagnosis, identifying 27 patients with exposure keratopathy. Retrospective chart review was performed. Underlying diagnoses, anatomic vs. paralytic nature of the exposure, best corrected visual acuity (BCVA) before and after the BOSP, and clinical challenges in the fitting and training process are reported.
The BOSP was fitted in 36 eyes in 27 patients referred for exposure keratopathy unresponsive to conventional therapy. 21 patients had exposure keratopathy of an anatomic nature (e.g. Goldenhar syndrome, cicatricial ectropion from thermal burns, blepharoplasty). 6 patients had exposure keratopathy of a paralytic nature (e.g. surgery for acoustic neuroma, Zoster cranial neuropathy). Previous failed treatment options included artificial tears, lubricating ointment, eyelid taping, punctal occlusion, tarsorrhaphy, bandage contact lenses, amniotic membrane application, lid weights, and lid retraction correction. Mean pre-BOSP BCVA was logMAR 0.69+/- 0.11, whereas mean post-BOSP BCVA was logMAR 0.27 +/- 0.06. This improvement was significant (paired samples t-test, t(34)= 4.405, p<0.001). Co-existent anatomic and/or paralytic pathology involving upper extremities did not interfere with lens insertion training.
The BOSP is a useful adjunct in the rehabilitation of exposure keratopathy. There is benefit in both paralytic and anatomic cases of exposure. Upper extremity dysfunction does not limit rehabilitation with this device.
This PDF is available to Subscribers Only