Abstract
Purpose: :
To determine the impact of wearing the Boston Ocular Surface Prosthesis (BOSP) on visual function in patients with ocular surface disease related to chronic graft-versus-host disease (cGvHD).
Methods: :
All patients referred to this institution for consideration of treatment with the BOSP (formerly known as Boston Scleral Lens) from January through June 2006 were administered the NEI VFQ-25 at entry, and again 6 months later. Our patient database was sorted by diagnosis identifying the cGvHD subgroup (n=16) in this cohort. The characteristics of this subgroup were extracted by data base analysis and retrospective chart review. This subgroup consists of 12 males and 14 females of ages 28 - 63 years (mean = 49). Underlying malignancy, type of transplant, and prior conventional ophthalmic therapy was tabulated and is reported. Baseline composite NEI VFQ-25 scores and self-reported general health status scores in this subgroup and scores at 6 month follow-up are reported, along with mean change in score. Scores are reported on scale 0 - 100, with 100 = highest level of function. The unpaired t-test was used to compare baseline composite scores of patients fitted vs. not fitted. The paired t-test was used to evaluate change in composite and self-reported general health score in those fitted.
Results: :
Mean baseline composite score on the NEI VFQ-25 was 62 (range 35-91, n=16). Of these 16 patients, 13 were fitted with the BOSP. Mean score for patients not fitted was 74 (n=3), whereas mean score for patients fitted was 59 (n=13), (P = 0.20, unpaired t-test ). NEI VFQ-25 scores of patients fitted and who had 6 month followup data (n=12), had mean = 57 (S.E = 5.06) at baseline and mean = 77 (S.E. = 5.52) at 6 months, with mean change in score = +20, (P <0.0003, paired t-test). Self-reported general health status was not significantly different at baseline (mean = 60) and 6 months (mean = 56, P=0.6147, paired t-test), in this group of patients. No patient categorized his or her general health as poor.
Conclusions: :
The BOSP significantly improves visual function in patients with ocular surface disease, unresponsive to conventional therapy, from cGvHD, in a sample that includes patients of both sexes, and a broad range of ages, underlying malignancies, and self-reported general health states. There was no concurrent improvement in general health status in this subgroup to explain this finding.
Keywords: cornea: clinical science • contact lens • quality of life