title: PROSE treatment for lagophthalmos and exposure keratopathy.
abstract: Prosthetic replacement of the ocular surface ecosystem is a treatment developed by the Boston Foundation for Sight that uses a Food and Drug Administration-approved prosthetic device for the treatment of severe ocular surface disease to improve vision and discomfort in addition to supporting the ocular surface. Facial nerve paralysis has multiple causes including trauma, surgery, tumor, stroke, and congenital lagophthalmos. Subsequent lagophthalmos leading to exposure keratitis has been treated with copious lubrication, tarsorrhapy, eyelid weights, chemodenervation to yield protective ptosis, and palpebral spring insertion. Each of these treatments, however, has limitations and potential complications. The prosthetic replacement of the ocular surface ecosystem device provides a liquid bandage to protect the cornea from eyelid interaction and dessication in addition to improving vision. This report describes 4 patients with exposure keratitis who were successfully treated with prosthetic replacement of the ocular surface ecosystem devices at 2 clinical sites.
authors.affiliation: Alkek Eye Center, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Anisa
authors.initials: A
authors.lastname: Gire
authors.forename: Alan
authors.initials: A
authors.lastname: Kwok
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Marx
mesh_terms: D000328:Adult; D003261:Contact Lenses; D003316:Corneal Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005141:Eyelid Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005155:Facial Nerve Diseases / Q000150:complications; D005158:Facial Paralysis / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications; D009883:Ophthalmic Solutions; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D020433:Trigeminal Nerve Diseases / Q000150:complications; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009883:Ophthalmic Solutions