Cressey Anna, Jacobs Deborah S, Remington Crystal, Carrasquillo Karen G
BostonSight, 464 Hillside Ave, Suite 205, Needham, MA, 02494, United States.
Massachusetts Eye and Ear, 243 Charles St., Boston, MA, 02114, United States.
Am J Ophthalmol Case Rep. 2018 Feb 15;10:108-113. doi: 10.1016/j.ajoc.2018.02.010. eCollection 2018 Jun.
To demonstrate clearing of chronic corneal opacities and improvement of visual acuity with the use of BostonSight prosthetic replacement of the ocular surface ecosystem (PROSE) treatment in ocular surface disease.
We undertook retrospective analysis of the medical records of a series of patients who underwent PROSE treatment from August 2006 to December 2014. Patients were referred for ocular surface disease of various etiologies. Primary inclusion criterion was corneal opacity that improved with PROSE treatment. Patients were excluded if topical steroids or adjuvant therapy used once PROSE treatment was initiated. Underlying disease, prior treatment, clinical presentation, and clinical course were extracted from the medical record. Four patients are included in this series. There were three females and one male; median age at time of treatment initiation was 30 years (range = 0.5-58 years). Median duration of PROSE treatment at time of retrospective analysis was 3.5 years (range = 1-8 years). Two cases had corneal opacification in the context of neurotrophic keratopathy: a unilateral case due to presumed herpes simplex keratitis and a bilateral case due to congenital corneal anesthesia associated with familial dysautonomia. One case had corneal opacity from exposure related to seventh nerve palsy, and one had corneal opacification associated with recurrent surface breakdown, neurotrophic keratopathy, and limbal stem deficiency of uncertain etiology. After consistent wear of prosthetic devices used in PROSE treatment for support of the ocular surface, visual acuity improved and clearing of the opacities was observed, without use of topical steroids or adjuvant therapy.
These cases demonstrate clearing of chronic corneal opacity with PROSE treatment for ocular surface disease. This clearing can occur with no adjuvant therapy, suggesting that restoration of ocular surface function and integrity allows for corneal remodeling.
通过在眼表疾病中使用波士顿视力眼表生态系统修复术（PROSE）治疗，证明慢性角膜混浊的清除以及视力的改善。
我们对2006年8月至2014年12月接受PROSE治疗的一系列患者的病历进行了回顾性分析。患者因各种病因的眼表疾病前来就诊。主要纳入标准是经PROSE治疗后角膜混浊有所改善。如果在开始PROSE治疗后使用了局部类固醇或辅助治疗，则将患者排除。从病历中提取基础疾病、既往治疗、临床表现和临床病程。本系列纳入4例患者。其中3例女性，1例男性；开始治疗时的中位年龄为30岁（范围=0.5 - 58岁）。回顾性分析时PROSE治疗的中位持续时间为3.5年（范围=1 - 8年）。2例在神经营养性角膜病变背景下出现角膜混浊：1例单侧病例因疑似单纯疱疹性角膜炎，1例双侧病例因与家族性自主神经功能异常相关的先天性角膜麻醉。1例因面神经麻痹导致暴露性角膜混浊，1例因复发性角膜上皮剥脱、神经营养性角膜病变和病因不明性角膜缘干细胞缺乏而出现角膜混浊。在持续佩戴PROSE治疗中用于支持眼表的假体装置后，视力得到改善，混浊消退，且未使用局部类固醇或辅助治疗。
这些病例证明了PROSE治疗眼表疾病可清除慢性角膜混浊。这种清除可在不使用辅助治疗的情况下发生，表明眼表功能和完整性的恢复可实现角膜重塑。
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