title: Treatment of Refractory Persistent Corneal Epithelial Defects: A Standardized Approach Using Continuous Wear PROSE Therapy.
abstract: OBJECTIVE
  To evaluate continuous wear of a fluid-ventilated, gas-permeable scleral PROSE device using a standardized protocol as treatment for refractory persistent corneal epithelial defects in patients with severe ocular surface disease.
  
  
  METHODS
  Retrospective review of eight eyes of seven consecutive patients with persistent epithelial defects refractory to traditional therapies. The standardized treatment regimen consisted of: (1) 24-hour-a-day PROSE wear until re-epithelialization was achieved, (2) brief daily device removal, cleaning, disinfection, and reservoir fluid replacement, (3) addition of a benzalkonium chloride (BAK)-free fourth-generation fluoroquinolone antibiotic drop to the reservoir, and (4) transition to long-term, daytime PROSE wear upon re-epithelialization.
  
  
  RESULTS
  All eight eyes exhibited resolution of the persistent epithelial defect. No eyes developed microbial keratitis. Four eyes exhibited recurrences; all recurrences promptly responded to reinstitution of continuous wear.
  
  
  CONCLUSIONS
  Continuous wear of a PROSE device, using a strictly standardized regimen, constitutes an effective, safe treatment option for refractory persistent epithelial defects.
authors.affiliation: Department of Ophthalmology, Weill Cornell Medical College, New York -Presbyterian , New York, NY , USA.
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Ciralsky
authors.forename: Kristin Ow
authors.initials: KO
authors.lastname: Chapman
authors.forename: Mark I
authors.initials: MI
authors.lastname: Rosenblatt
authors.forename: Priyanka
authors.initials: P
authors.lastname: Sood
authors.forename: Ana G Alzaga
authors.initials: AG
authors.lastname: Fernandez
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Lee
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Sippel
mesh_terms: D000368:Aged; D003262:Contact Lenses, Extended-Wear; D003316:Corneal Diseases / Q000473:pathology / Q000628:therapy*; D019573:Epithelium, Corneal / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
keywords: Corneal disease; PROSE; ocular surface disease; persistent epithelial defect; scleral lens