title: Clinical Experience With PROSE Fitting: Significance of Diagnosis and Age.
abstract: OBJECTIVE
  To compare ease of adoption of the BostonSight Prosthetic Replacement of the Ocular Surface Ecosystem device, a custom-fit scleral lens, by patients in different age and diagnosis groups.
  
  
  METHODS
  In this prospective study, patients were categorized by age as younger than 60 or 60 years and older and by diagnosis as corneal irregularity (CI) or ocular surface disease (OSD). Ease of adoption of the scleral device was assessed by (1) number of devices and visits required to complete the fitting process, (2) time needed for device insertion and removal, (3) adaptation to the device, as assessed by daily wear time and by time needed to achieve full-time wear (defined as 8 hours per day), and (4) patients' subjective rating of ease of device insertion and removal. The length of the fitting process was also assessed.
  
  
  RESULTS
  There was no significant difference in the number of devices and visits needed between age group younger than 60 and age group of 60 and older or between CI and OSD groups. Patients in all groups achieved full-time wear in less than 2 weeks. Average wear time per week did not differ significantly between age or diagnosis groups. Similarly, the time needed for daily insertion and removal during the fitting period, as well as patients' subjective rating of ease of device insertion and removal, did not differ between age or diagnosis categories. The length of the fitting process was significantly longer in the OSD group compared with the CI group (P<0.001); however, factors not related to ease of adoption of the scleral device may be responsible for this difference.
  
  
  CONCLUSIONS
  Patients in both younger and older patient groups adopted the use of a scleral device with equal ease, as did patients in the CI and OSD diagnosis groups.
authors.affiliation: Department of Ophthalmology (D.L.K., E.D., Y.W., R.S., M.N.L., P.S., A.A.F., J.B.C., K.C.S.), Weill Cornell Medical College, New York, NY; and Department of Ophthalmology and Visual Sciences (M.I.R.), University of Illinois at Chicago, Chicago, IL.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Kornberg
authors.forename: Eda
authors.initials: E
authors.lastname: Dou
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Wang
authors.forename: Ryan
authors.initials: R
authors.lastname: St Clair
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Lee
authors.forename: Priyanka
authors.initials: P
authors.lastname: Sood
authors.forename: Ana Alzaga
authors.initials: AA
authors.lastname: Fernandez
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Ciralsky
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Sippel
authors.forename: Mark I
authors.initials: MI
authors.lastname: Rosenblatt
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D003261:Contact Lenses; D003316:Corneal Diseases / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D017755:Prosthesis Fitting / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012590:Sclera; D014792:Visual Acuity