Department of Ophthalmology and Visual Sciences (K.H.K., K.S.D., C.T.H.), W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI; and Department of Ophthalmology (K.H.K.), Inje University College of Medicine; and Haeundae Paik Hospital, Busan, South Korea.
Eye Contact Lens. 2020 Nov;46(6):359-363. doi: 10.1097/ICL.0000000000000685.
To evaluate the clinical outcomes of patients with limbal stem cell deficiency (LSCD) who were fitted with the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral device.
In this retrospective, interventional case series, we reviewed the charts of 31 eyes of 19 consecutive patients clinically diagnosed with LSCD who were evaluated for the PROSE device. Clinical data were reviewed before PROSE evaluation and at the last available follow-up. The main outcomes measures were best-corrected distance visual acuity (CDVA) and modified ocular involvement score (OIS), graded using a previously described system for corneal findings.
Corrected distance visual acuity improved from 0.86±0.50 logarithm of the minimal angle of resolution (Snellen equivalent, 20/145) at baseline to 0.46±0.44 (Snellen equivalent, 20/58) with PROSE at the last follow-up (mean, 25.1±18.0 months; P<0.0001). In 27 eyes (87.1%) CDVA improved, with 22 eyes (71.0%) gaining 2 or more lines of Snellen acuity. When categorized by disease severity, CDVA improved in less severe eyes (stage 1) and more severe eyes (stage 2 or 3; P=0.049 and P=0.00009, respectively). Total OIS was not significantly different between baseline and last follow-up (P=0.754); however the epithelial defect score was significantly less (P=0.034). Twenty-four of 31 eyes (77.4%) continued wearing the PROSE device, with a mean daily wearing time of 10.0±4.6 hrs.
In patients with LSCD, vision improved and the OIS remained stable with PROSE, suggesting that the device could be considered for visual rehabilitation in this population.
评估患有边缘干细胞缺乏症（LSCD）的患者佩戴 Prosthetic Replacement of the Ocular Surface Ecosystem（PROSE）巩膜装置的临床结果。
在这项回顾性的干预性病例系列研究中，我们回顾了 19 例连续患者的 31 只眼的图表，这些患者临床诊断为 LSCD，正在接受 PROSE 装置评估。在 PROSE 评估前和最后一次可获得的随访时，评估了临床数据。主要观察指标为最佳矫正远视力（CDVA）和改良眼受累评分（OIS），使用先前描述的角膜发现系统进行分级。
矫正远视力从基线时的 0.86±0.50 对数最小角分辨率（Snellen 等价物，20/145）提高到最后一次随访时的 0.46±0.44（Snellen 等价物，20/58）（平均，25.1±18.0 个月；P<0.0001）。在 27 只眼中（87.1%），CDVA 提高，22 只眼（71.0%）提高了 2 行或更多的 Snellen 视力。按疾病严重程度分类，在病情较轻的眼（1 期）和病情较重的眼（2 期或 3 期）中，CDVA 有所改善（P=0.049 和 P=0.00009）。基线和最后一次随访时的总 OIS 无显著差异（P=0.754）；然而，上皮缺损评分明显降低（P=0.034）。31 只眼中的 24 只（77.4%）继续佩戴 PROSE 装置，平均每天佩戴时间为 10.0±4.6 小时。
在 LSCD 患者中，PROSE 可改善视力，OIS 保持稳定，表明该装置可考虑用于该人群的视力康复。
