title: Use of the Boston Ocular Surface Prosthesis in the management of severe periorbital thermal injuries: a case series of 10 patients.
abstract: OBJECTIVE
  To report the use of the Boston Ocular Surface Prosthesis (BOSP) in patients with severe periorbital thermal injuries.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Patients with severe periorbital thermal injuries treated with the BOSP.
  
  
  METHODS
  Chart review of 10 consecutive patients (16 eyes) who sustained severe periorbital thermal injuries during combat missions in Iraq and Afghanistan and were treated for exposure keratopathy with the BOSP, a Food and Drug Administration-approved gas-permeable, scleral contact lens.
  
  
  METHODS
  Corneal epithelial defect healing, uncorrected and best-corrected visual acuity, and BOSP wear time.
  
  
  RESULTS
  Exposure keratopathy occurred after severe periorbital thermal injuries and followed a predictable course of scar contracture. In all patients, vision-threatening ocular surface disease developed as a result of chronic ocular exposure. Rehabilitation of the ocular surface was accomplished using the BOSP, with 10 of the 16 treated eyes achieving a corrected visual acuity of 20/70 or better. Five eyes achieved a best-corrected visual acuity of 20/40 or better. The BOSP also was used as a drug-delivery vehicle to treat corneal ulcers successfully in 6 eyes. The only eye that required penetrating keratoplasty was an early intervention believed to be a direct sequelae of the original thermal burn, rather than a failure of the BOSP regimen. The mean BOSP wear time was 16 hours per day.
  
  
  CONCLUSIONS
  The BOSP can play an important role in rehabilitation of the ocular surface for patients with severe periorbital thermal injuries and resultant exposure keratopathy. Use of the BOSP should be considered as a treatment option for these difficult cases of severe periorbital thermal injuries.
authors: San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA. MyEyeQuestions@gmail.com
authors: Kevin
authors: K
authors: Kalwerisky
authors: Brett
authors: B
authors: Davies
authors: Lisa
authors: L
authors: Mihora
authors: Craig N
authors: CN
authors: Czyz
authors: Jill A
authors: JA
authors: Foster
authors: Sheri
authors: S
authors: DeMartelaere
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001753:Blast Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D003261:Contact Lenses; D003315:Cornea / Q000503:physiopathology; D065306:Corneal Injuries; D003320:Corneal Ulcer / Q000503:physiopathology / Q000534:rehabilitation*; D005126:Eye Burns / Q000503:physiopathology / Q000534:rehabilitation*; D005143:Eyelids / Q000293:injuries; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D009915:Orbit / Q000293:injuries; D019736:Prostheses and Implants; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult