Bhattacharya Pradipta, Mahadevan Rajeswari
Department of Contact Lens, Sankara Nethralaya, Medical Research Foundation, Chennai, India.
Elite School of Optometry, Sankara Nethralaya, Medical Research Foundation, Chennai, India.
Clin Exp Optom. 2017 Nov;100(6):710-717. doi: 10.1111/cxo.12519. Epub 2017 Mar 12.
PROSE (prosthetic replacement of ocular surface ecosystem) device is a custom-designed, corneal vaulting scleral contact lens, which is used in the treatment of irregular corneal conditions to improve vision and comfort. The present study aimed at assessing the success of the PROSE device in an Indian scenario in terms of change in quality of life and to understand the handling issues related to the device use.
Thirty-two subjects with various irregular corneal conditions meeting the inclusion criteria were included in the study. Subjects were followed for three months after dispensing the PROSE device. Subjects' demographic details, high and low contrast visual acuity with habitual correction and PROSE device, Visual Function Questionnaire scores (NEI VFQ-25) and Ocular Surface Disease Index (OSDI) scores pre- and post-PROSE treatment were collected and compared. An indigenously developed questionnaire was also administered during the follow-up visit for assessing the handling-related issues faced by the subjects while using the device.
Forty eyes of 32 subjects were included in the study, of whom 30 reported for follow-up. The median NEI VFQ-25 score improved from 47.33 points to 77.27 points over a period of three months, which was statistically significant (p < 0.05). There was a statistically significant decrease in median OSDI score from 51.14 points to 13.63 points post-PROSE treatment (p < 0.05). Subjects reported no or very minimal handling-related difficulties associated with the use of the PROSE device.
The PROSE treatment can be an effective mode of managing patients with irregular corneal conditions and significantly improved the vision-related quality of life of patients suffering from these conditions. The handling of the device is easy and can be mastered with adequate training.
PROSE（眼表生态系统假体置换）装置是一种定制设计的角膜隆凸巩膜接触镜，用于治疗不规则角膜疾病，以改善视力和舒适度。本研究旨在评估PROSE装置在印度情况下对生活质量变化的治疗效果，并了解与该装置使用相关的操作问题。
32名符合纳入标准的各种不规则角膜疾病患者纳入本研究。在分发PROSE装置后对受试者进行了三个月的随访。收集并比较了受试者的人口统计学细节、使用习惯性矫正和PROSE装置时的高对比度和低对比度视力、视觉功能问卷评分（NEI VFQ-25）以及PROSE治疗前后的眼表疾病指数（OSDI）评分。在随访期间还发放了一份自主研发的问卷，以评估受试者在使用该装置时面临的与操作相关的问题。
32名受试者的40只眼睛纳入本研究，其中30名进行了随访。在三个月的时间里，NEI VFQ-25评分中位数从47.33分提高到77.27分，差异具有统计学意义（p < 0.05）。PROSE治疗后，OSDI评分中位数从51.14分降至13.63分，差异具有统计学意义（p < 0.05）。受试者报告在使用PROSE装置时没有或只有非常轻微的与操作相关的困难。
PROSE治疗可以成为治疗不规则角膜疾病患者的有效方式，并显著改善患有这些疾病患者的视力相关生活质量。该装置易于操作，经过适当培训即可掌握。
