PROSE treatment of corneal ectasia.
OBJECTIVE
Prosthetic replacement of the ocular surface ecosystem (PROSE) uses custom designed and fabricated prosthetic devices in a treatment that restores vision, supports healing, reduces symptoms and improves quality of life in patients with complex corneal disease. We report the success rate for PROSE treatment of corneal ectasia.


METHODS
Records of 59 patients with corneal ectasia seen in consultation over 6 months were reviewed. Candidacy for treatment, topographic indices, change in visual acuity, achievement of satisfactory fit, device wear status and change in visual function at 6 months were recorded.


RESULTS
Sixteen eyes were non-candidates because conventional correction was adequate. Trial devices were inserted but not dispensed for 13 eyes. No eyes were excluded for severity of ectasia. In the remaining 89 eyes, satisfactory fit was achieved and a device was dispensed. Twenty-one eyes (15 patients) had undergone penetrating keratoplasty. Device wear at 6 months was documented in 78/89 eyes (88%). NEI VFQ-25 score improved 27.6 points (p<0.001) on a 100 point scale in patients wearing a device at 6 months.


CONCLUSIONS
All candidate eyes with corneal ectasia could be fitted with a PROSE device. PROSE treatment has a high success rate when measured by ability to achieve satisfactory fit, impact on visual acuity and 6 month data on both rate of continued wear and impact on visual function. PROSE treatment is an alternative to penetrating keratoplasty for patients with corneal ectasia who are contact lens intolerant.
Boston Foundation for Sight, Needham, MA 02494, United States.
Inna
I
Baran
James A
JA
Bradley
Fateme
F
Alipour
Perry
P
Rosenthal
Hong-Gam
HG
Le
Deborah S
DS
Jacobs
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000601:surgery*; D004108:Dilatation, Pathologic / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D019544:Equipment Failure Analysis; D005137:Eye, Artificial; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D055815:Young Adult