Purchase this article with an account.
Tova Mannis, Dianne Bach, Gloria Chiu, Simon Bababeygy, John Irvine, J. Martin Heur; Improvements in visual acuity and function with Prosthetic Replacement of the Ocular Surface Ecosystem scleral lens in patients with ocular surface disease. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3908.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the results of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lens on visual acuity and function in patients with ocular surface disease who had failed conventional treatment.
A retrospective chart review of 75 individuals (132 eyes) with ocular surface disease fitted with PROSE lenses at Doheny Eye Institute between July 2009 and December 2011 was performed. Patients with ocular surface disease, including dry eye, graft versus host disease (GVHD), Sjogren syndrome, Stevens Johnson syndrome (SJS) and exposure keratopathy, who failed conventional treatment were evaluated to determine whether they were candidates for PROSE. Those who were determined to be candidates and pursued a new fitting were included in this study. Best corrected visual acuity prior to PROSE fitting was measured at the initial visit and post-PROSE visual acuity was measured at completion of the fitting using Snellen chart. Visual function, pre and post PROSE fitting, was assessed using the Ocular Surface Disease Index (OSDI). Pre-PROSE OSDI score was obtained at the initial consultation visit and post-PROSE OSDI score were obtained several months after the last fitting via telephone by a trained interviewer not involved in the patient’s care.
All groups of patients experienced improvements in visual acuity and function following PROSE fitting. Patients with GVHD showed the biggest improvement in logMAR visual acuity, 0.51 pre-PROSE vs 0.083 post-PROSE (p = 1.3E-9) followed by patients with dry eyes, 0.34 pre-PROSE vs 0.10 post-PROSE (p = 1.5E-8) and Sjogren syndrome, 0.19 pre-PROSE vs 0.048 post-PROSE (p = 0.00055). Patients with SJS and exposure keratopathy also showed improved visual acuity, but these results were not statistically significant. GVHD patients also showed the biggest improvement in OSDI scores, 75.0 pre-PROSE vs 16.3 post-PROSE (p = 0.00015), followed by dry eye patients, 60.0 pre-PROSE vs 22.7 post-PROSE. Sjogren syndrome, SJS, and exposure keratopathy patients trended toward improved OSDI scores but their results did not achieve statistical significance.
The results of this study showed that in cases of ocular surface disease refractory to conventional management, the PROSE lens can improve both visual acuity and visual function, particularly in patients with GVHD.
This PDF is available to Subscribers Only