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Prosthetic replacement of the ocular surface ecosystem (PROSE) for the treatment of limbal stem cell deficiency

Poster Details

First Author: K.Kim SOUTH KOREA

Co Author(s):    K. Deloss   C. Hood                 

Abstract Details

Purpose:

Limbal stem cell deficiency (LSCD) can have significant ocular morbidity, but current medical and surgical treatments are often inadequate or have significant risks. We hypothesized that the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE), a scleral lens that rests on the limbus, would improve visual function in patients with LSCD. This retrospective, consecutive, interventional case series, therefore, evaluated clinical outcomes of the PROSE device in patients diagnosed with LSCD secondary to a variety of etiologies.

Setting:

Department of Ophthalmology and Vision Science, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States

Methods:

We included 31 eyes of 19 patients from November 2010 to April 2016 who were diagnosed clinically with LSCD and dispensed PROSE. The main outcomes were visual acuity and ocular involvement score (OIS), graded using a previously described system for corneal and conjunctival findings. Eight components of ocular involvement were scored from 0 to 3 according to severity.

Results:

The CDVA improved in 27 eyes (87.1%). Mean CDVA improved from 0.86�Â�±0.50 logMAR (Snellen equivalent 20/146) at baseline to 0.46�Â�±0.44 at last follow-up (P<0.0001). When categorized by disease severity, CDVA improved in less severe eyes (OIS 6) as well as more severe eyes (OIS �â�‰�¥7, P=0.00016 and P=0.017, respectively). Mean total ocular involvement score was not significantly different before and after PROSE wear (P=0.645), however mean epithelial defect score was significantly less at last follow-up (P=0.034). For all other components of the OIS there were no significant differences from baseline to final follow-up.

Conclusions:

PROSE improved visual acuity in patients with LSCD without an overall change in ocular involvement score, suggesting that the ocular surface may be stabilized with device wear.

Financial Disclosure:

NONE

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