Scofield-Kaplan Stacy M, Dunbar Kristen E, Campbell Ashley A, Kazim Michael
Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, New York, U.S.A.
Ophthalmic Plast Reconstr Surg. 2018 May/Jun;34(3):242-245. doi: 10.1097/IOP.0000000000000934.
To describe the use of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) device in the management of complex oculoplastic pathology.
The authors retrospectively reviewed the records of individuals over 18 years of age who were referred and successfully fit with the PROSE scleral device between January 1995 and June 2015.
Nine cases were identified that had complex oculoplastic disease and severe corneal surface disease. All patients with ptosis had improvement in marginal reflex distance-1 following PROSE and 5 of 7 patients with ptosis were spared further surgical intervention. Two underwent surgical repair with successful corneal stabilization with PROSE. Those with eyelid malposition including ectropion, entropion, or trichiasis experienced improvement in their corneal surface and deferred further surgical intervention.
These cases highlight the use of the PROSE device to elevate the upper eyelid in patients with lagophthalmos and ptosis, stabilize the corneal surface to allow for additional eyelid surgery to be performed safely, and protect the corneal surface in patients with intractable trichiasis and entropion. Prosthetic Replacement of the Ocular Surface Ecosystem should be considered in patients with complex oculoplastic pathology to improve visual function, corneal surface disease, and eyelid position.
描述眼表生态系统修复假体（PROSE）装置在复杂眼整形病理学管理中的应用。
作者回顾性分析了1995年1月至2015年6月期间转诊并成功适配PROSE巩膜装置的18岁以上患者的记录。
确定了9例患有复杂眼整形疾病和严重角膜表面疾病的病例。所有上睑下垂患者在使用PROSE后睑缘反射距离-1均有改善，7例上睑下垂患者中有5例无需进一步手术干预。2例接受手术修复，使用PROSE后角膜成功稳定。那些有眼睑位置异常（包括睑外翻、睑内翻或倒睫）的患者角膜表面情况有所改善，并推迟了进一步的手术干预。
这些病例突出了PROSE装置在睑裂闭合不全和上睑下垂患者中提升上睑、稳定角膜表面以便安全地进行额外眼睑手术以及在难治性倒睫和睑内翻患者中保护角膜表面的应用。对于患有复杂眼整形病理学的患者，应考虑使用眼表生态系统修复假体来改善视觉功能、角膜表面疾病和眼睑位置。
