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Elizabeth Marlow, Jessica Ciralsky, Michelle Lee, Gary Lelli; PROSE lens use for exposure keratopathy in trigeminal and facial nerve palsies. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3861.
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© ARVO (1962-2015); The Authors (2016-present)
For patients with severe ocular surface disease, prosthetic replacement of the ocular surface ecosystem (PROSE) devices have shown efficacy in improving visual acuity and the ocular surface. Individuals with facial and trigeminal nerve palsies are at particularly high risk for exposure keratopathy, making PROSE a potentially beneficial tool in the management of these cases. This retrospective, observational clinical study reviewed the effects of initiating PROSE wear on nine eyes affected by facial (VII), trigeminal (V1), or both (VII and V1) cranial nerve palsies.
Best corrected visual acuity (BCVA) at the initial PROSE fitting, three months after initiating PROSE wear, and BCVA achieved at any time after starting PROSE wear were compared. In addition, the quality of the ocular surface before starting PROSE and at the time of longest PROSE wear was compared.
After three months of PROSE wear, patients gained an average of 0.9 ± 1.4 lines on the Snellen eye chart compared to initial BCVA. The average maximal gain in lines on the Snellen eye chart achieved at any time after starting PROSE was 1.9 ± 1.3 lines, which occurred an average of 5.3 ± 5.4 months after starting PROSE wear. The ocular surface quality improved in 8 out of 9 eyes with the resolution of punctate epithelial erosions (n = 7), reduced corneal haze (n = 2), and reduced mucus strands (n = 2) being the most commonly sited changes.
These findings show that the PROSE device can be an effective tool in the management of exposure keratopathy secondary to trigeminal (V1) and facial nerve palsies.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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