Free Papers

Indications and Outcomes of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) – A Canadian Experience

Free Paper Details

First Author: B.Wong CANADA

Co Author(s):    A. Garg   T. Trinh   S. Ramdass   J. Liao   C. Chan   A. Slomovic     

Abstract Details

Purpose:

To investigate the indications and outcomes of the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) lens in patients with distorted corneal surfaces and ocular surface diseases (OSD) at the first Canadian PROSE centre.

Setting:

This study was conducted at the Kensington Eye Institute, Toronto, Canada.

Methods:

A retrospective chart review was conducted on 78 patients (126 eyes) referred for PROSE treatment from 2018 to 2020. Patients were fit with PROSE and were dispensed lenses that were customized for each eye. Based on their main diagnosis indicating PROSE, patients were categorized into one of two groups: distorted corneal surface or OSD. Data were collected on diagnoses, presenting symptoms, previous lens modalities attempted, best corrected visual acuities (BCVA) pre and post PROSE, daily wear time, and failure rate. BCVAs pre and post PROSE were compared to evaluate visual improvement.

Results:

The most common diagnoses were keratoconus (n=39 eyes) and post-corneal graft (n=15) in the distorted cornea group, and limbal stem cell deficiency (n=17) and graft versus host disease (n=15) in the OSD group. Most frequent symptoms included blur, photophobia, and pain. Most common lens modalities attempted pre-PROSE were conventional scleral lenses, glasses, and corneal gas permeable lenses. Overall mean BCVA improvement was 0.40 logMAR (4-lines Snellen) (P<0.0001). BCVA improvement in the distorted cornea group (0.52 logMAR, 5-lines) was significantly greater than in the OSD group (0.29 logMAR, 3-lines) (P=0.004). Over the period analyzed, 2 patients (3 eyes) failed PROSE wear.

Conclusions:

PROSE treatment can provide significant improvements in visual acuity for patients with distorted corneal surfaces and OSDs who have previously failed in other lens modalities.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a competing company