The Boston Scleral Lens in the management of severe ocular surface disease

The Boston Scleral Lens in the treatment of pediatric patients

“…16 The current series shows that children from 7 months to 13 years of age with congenital corneal anesthesia, younger than previously reported, can be treated with the Boston Scleral Lens, as well as those with associated palsy in Möbius' and Goldenhar syndromes. Cost, lack of general availability, necessity of travel to Massachusetts for fitting, and duration and complexity of the fitting process are barriers to greater utilization of the Boston Scleral Lens.…”

Prosthetic Replacement of the Ocular Surface Ecosystem as Treatment for Ocular Surface Disease in Patients with a History of Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis

“…7 Prosthetic replacement of the ocular surface ecosystem (PROSE) is a treatment that uses custom-designed and customfabricated prosthetic devices to replace or augment the impaired ocular surface functions in patients with complex corneal disease. 8,9 BostonSight PROSE treatment was developed by the Boston Foundation for Sight, Needham, Massachusetts, and is available at over a dozen centers in the United States and internationally (available from www.bostonsight. org).…”

“…A PROSE device (previously known as the Boston scleral lens prosthetic device 10 ) is a gas-permeable, large-diameter lens that vaults the cornea and submerges the entire corneal surface in a pool of oxygenated artificial tears. 9,11 Because of its high oxygen permeability, fluid-filled reservoir, lack of corneal contact, positional stability on the eye, and protection from lid-related shear forces, a PROSE device creates an environment that supports healing and maintenance of the corneal epithelium. Each prosthetic device is custom designed and manufactured per eye using computer-aided design.…”

Scleral Contact Lenses

“…The Boston Scleral lenses 7 constitute the prosthetic replacement of the ocular surface eco-system The prosthetic device is made from an oversized button of itafluorocon B(Equalens II),a fluro-silicon/acrylate polymer of Dk value 87 x10-11 units. Each device is highly customized in its design and fabrication to address the circumstances and needs of the eyes ocular surface.…”