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Prosthetic scleral lens can improve visual acuity as conservative measure

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Bryam Roth

WASHINGTON — The prosthetic replacement of ocular surface ecosystem scleral lens can improve vision in patients seeking a conservative alternative to surgery, according to a speaker.

“We found that PROSE can improve vision in patients with a wide variety of etiologies,” Bryan M. Roth, MD, said at the American Society of Cataract and Refractive Surgery meeting, where he presented results of a study done at Baylor College of Medicine aimed at assessing the impact of PROSE use on visual acuity.

Roth described the BostonSight PROSE device as “a large-diameter scleral contact lens with the distinguishing feature of large corneal bulk that enables it to be fit in other eyes with severe ocular irregularities, severe corneal ectasia that could not be fit by more conservative means.”

The retrospective chart review analyzed 825 eyes of 490 patients who were fit with the lens at Baylor from 2010 to 2016 for either distorted, irregular cornea or ocular surface disease. In both categories, PROSE statistically significantly improved visual acuity from pre-PROSE values (both P < .001).

When the irregular cornea group was broken down into subcategories of corneal scars and dystrophies, postsurgical irregularity and primary ectasia etiologies, statistically significant improvement was seen in each group.

“We had significant improvement in every single sub-etiology that we looked at,” he said. Similarly, there was statistically significant improvement in each sub-etiology of ocular surface disease, including dry eye syndrome, limbal stem cell deficiency, neurotrophic keratopathy, corneal exposure, graft vs. host disease and Stevens-Johnson syndrome.

PROSE should be considered in patients who have failed other conservative treatment measures or in patients who desire improvement in visual acuity without surgical intervention, Roth said. – by Patricia Nale, ELS

Reference:

Roth BM. Assessment of prosthetic replacement of ocular surface ecosystem scleral lens on visual acuity. Presented at: American Society of Cataract and Refractive Surgery annual meeting; April 13-17, 2018; Washington.

Disclosure: Roth reports no relevant financial disclosures.