Faculty of Medicine (B.M.W. and A.G.), University of Toronto, Toronto, Canada; Department of Ophthalmology and Vision Sciences (T.T., M.M., M.C., C.C.C., and A.R.S.), University of Toronto, Toronto, Canada; Kensington Eye Institute (T.T., M.M., S.R., J.L., M.C., C.C.C., and A.R.S.), Toronto, Canada; and New England College of Optometry (J.L.), Boston, MA.
Eye Contact Lens. 2021 Jul 1;47(7):394-400. doi: 10.1097/ICL.0000000000000779.
To investigate underlying diagnoses and outcomes of patients undergoing Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment at the first Canadian PROSE center.
A retrospective chart review was conducted on patients referred for PROSE treatment and fitted with PROSE devices from 2018 to 2020. Data were collected on diagnoses, presenting symptoms, previous lens modalities attempted, best-corrected visual acuities (BCVAs) pre-PROSE and post-PROSE, daily wear time, and failure rates. Best-corrected visual acuities pre-PROSE and post-PROSE were compared to evaluate visual improvement.
In total, 78 patients (126 eyes) were analyzed. The most common diagnoses were keratoconus (n=39 eyes) and postcorneal graft (n=15) in the distorted cornea group, and limbal stem cell deficiency (n=17) and graft versus host disease (n=15) in the ocular surface disease (OSD) group. Most frequent symptoms included blur, photophobia, and pain. Most common lens modalities attempted pre-PROSE were conventional scleral lenses and glasses. The overall mean BCVA improvement was 0.40 logarithm of the minimal angle of resolution (logMAR) (4-lines Snellen) (P<0.0001). Best-corrected visual acuities improvement in the distorted cornea group (0.52 logMAR, 5-lines) was significantly greater than in the OSD group (0.29 logMAR, 3-lines) (P=0.004).
Prosthetic replacement of the ocular surface ecosystem treatment can provide significant visual improvement for patients with distorted corneal surfaces and OSDs who failed other lens modalities.
调查加拿大首家 PROSE 中心接受 Prosthetic Replacement of the Ocular Surface Ecosystem（PROSE）治疗的患者的潜在诊断和结局。
对 2018 年至 2020 年因 PROSE 治疗和 PROSE 设备适配而转诊的患者进行回顾性图表审查。收集的资料包括诊断、症状、尝试的先前镜片方式、PROSE 治疗前和治疗后的最佳矫正视力（BCVA）、日戴时间和失败率。比较 PROSE 治疗前后的最佳矫正视力以评估视力改善情况。
共分析了 78 例患者（126 只眼）。在变形角膜组中，最常见的诊断是圆锥角膜（n=39 只眼）和角膜移植后（n=15 只眼），在眼表面疾病（OSD）组中，最常见的诊断是边缘干细胞缺陷（n=17 只眼）和移植物抗宿主病（n=15 只眼）。最常见的症状包括模糊、畏光和疼痛。PROSE 治疗前最常尝试的镜片方式是常规巩膜镜片和眼镜。总体平均 BCVA 改善为 0.40 对数最小角分辨率（logMAR）（4 行 Snellen）（P<0.0001）。变形角膜组的最佳矫正视力改善（0.52 logMAR，5 行）明显大于 OSD 组（0.29 logMAR，3 行）（P=0.004）。
对于其他镜片方式治疗失败的变形角膜和 OSD 患者，眼表面生态系统假体置换治疗可显著提高视力。
