Management of Vascularized Limbal Keratitis With Prosthetic Replacement of the Ocular Surface System

Abstract

PROSE, by normalizing the environment at the ocular surface, ultimately improved visual function and long-term ocular health for this patient.

What Makes a Scleral Lens Fit Physiological? A Case Report

“…In the clinical setting, case studies have shown that scleral lenses can have a therapeutic effect on compromised corneas. Cressey et al, demonstrated resolution of vascularized limbal keratitis similar to the appearance of the present case [18]. Resolution of recalcitrant persistent epithelial defects have also been observed with PROSE treatment suggesting that there is a beneficial and therapeutic effect conferred onto the ocular surface with PROSE devices or scleral lenses [19][20][21].…”

Scleral Lenses

“…Utilization of a scleral lens with an occlusive piggyback hydrogel lens for management of amblyopia in an infant with familial dysautonomia has been described. 76,82 Reduction of corneal scarring due to vascularized limbal keratitis with long-term wear of a scleral lens has been reported, 81 as has maintenance of corneal surface integrity after discontinuation of scleral lens treatment for limbal stem-cell deficiency. 125 Scleral lenses have been used to protect the ocular surface during treatment for head and neck malignancy 75 and staged eyelid reconstructive surgery 90 and to deliver medication to the ocular surface.…”

“…Cotter and Rosenthal 69 Rosenthal et al 70 Rosenthal and Cotter 71 Rosenthal and Croteau 72 Jacobs and Rosenthal 73 Gungor et al 74 Lin et al 75 Lim et al 76 Grover et al 77 Gumus et al 78 Rathi et al 79 Baran et al 80 Cressey et al 81 Kalwerisky et al 82 Rathi et al 83,84 Dimit et al 85 Gire et al 86 Lee et al 87 Lim et al 88 Ling et al 89 Samimi et al 90 Arumugan et al 91 Ciralsky et al 92 Heur et al 93 Mahadevan et al 94 Rose K (Blanchard Contact Lens, Manchester, NH)…”

Ultra-high resolution and long scan depth optical coherence tomography with full-phase detection for imaging the ocular surface

“…Prosthetic replacement of the ocular surface environment (PROSE) devices are large in diameter, and have vaulted scleral lenses with a liquid reservoir that are used to protect the eye surface, thus promoting healing and restoring sight in injured and diseased eyes 4,5. These devices have been used to treat corneal ectasia, exposure keratopathy, vascularized limbal keratitis, and are useful for improving visual function in subjects with these conditions 4–8. However, PROSE is not widely used because the current fitting procedure, which involves multiple trial lenses, is time-consuming and costly 4.…”

“…These devices have been used to treat corneal ectasia, exposure keratopathy, vascularized limbal keratitis, and are useful for improving visual function in subjects with these conditions 4–8. However, PROSE is not widely used because the current fitting procedure, which involves multiple trial lenses, is time-consuming and costly 4. An automated fitting procedure would reduce costs and time, improve results, and allow a greater number of patients to be treated.…”