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Br J Ophthalmol. 2016 Sep;100(9):1171-5. doi: 10.1136/bjophthalmol-2015-307483. Epub 2015 Dec 7.

Prosthetic replacement of the ocular surface ecosystem: impact at 5 years.

Author information

1
Boston Foundation for Sight, Needham, Massachusetts, USA Boston University School of Medicine, Boston, Massachusetts, USA.
2
Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.
3
Boston Foundation for Sight, Needham, Massachusetts, USA.

Abstract

BACKGROUND/AIMS:

To determine the impact of prosthetic replacement of the ocular surface ecosystem (PROSE) treatment at 5 years.

METHODS:

Retrospective review of clinical, manufacturing and quality databases at the Boston Foundation for Sight.

RESULTS:

121 patients who completed treatment and had 5-year follow-up data were identified from a cohort of patients (n=199) seen in consultation for PROSE treatment from January 2008 to June 2008. Mean age was 52 years, M:F=56:65. The primary indication for treatment was ocular surface disease (OSD) in 64 patients and distorted corneal surface in 57 patients. At 5 years, continued device wear was confirmed in 89/121 (73.6%) patients. Discontinuation of wear was confirmed in 32/121 (26.4%). There was an increased likelihood of continued device wear at 5 years in patients with distorted cornea (84%) compared with those with OSD (64%), (p=0.0121, χ(2)). National Eye Institute Visual Function Questionnaire (NEI VFQ-25) composite score increased for patients wearing PROSE devices at 6 months (Δ=+23 points, mean=82, p<0.001, two-tailed t test) with no significant decline among those still wearing a device at 5 years (Δ=-4 points, mean=78, p=0.22, two-tailed t test). At 5 years, those wearing (mean=78) had a higher NEI VFQ-25 than those not wearing (mean=70, p=0.029, two-tailed t test).

CONCLUSIONS:

PROSE treatment offers continued benefit, as defined by improved visual function and continued device wear at 5 years, in patients with complex corneal disease. Patients with distorted cornea have a higher rate of continued wear at 5 years than patients with OSD, although this is not true among all subgroups within OSD.

KEYWORDS:

Contact lens; Cornea; Ocular surface; Prosthesis; Vision

PMID:
26644423
PMCID:
PMC5013114
DOI:
10.1136/bjophthalmol-2015-307483
[Indexed for MEDLINE]
Free PMC Article

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