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Case Series: Overnight Wear of Scleral Lens for Persistent Epithelial Defects

He, Xu, MD1; Donaldson, Kendall, E., MD, MS1; Perez, Victor, L., MD1,2; Sotomayor, Priscilla, OD1*

doi: 10.1097/OPX.0000000000001162

SIGNIFICANCE This case series demonstrates successful use of PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) for overnight wear among patients with persistent epithelial defects, while exploring the efficacy of using PROSE reservoir for autologous hematopoietic products during treatment.

PURPOSE This case series proposes a strategic approach to the treatment of refractory cases of persistent epithelial defect via overnight PROSE device wear.

CASE REPORTS We followed three patients with persistent epithelial defect treated with PROSE devices and observed expedited defect resolution and improvement in best-corrected visual acuity over the course of 2 to 4 weeks. In addition to moxifloxacin and preservative-free saline, autologous hematopoietic products were added to the reservoir of two patient’s PROSE devices. Patients were advised to wear their PROSE device at all times except for lens cleaning and replacement of reservoir contents every 12 hours.

CONCLUSIONS Together, these cases demonstrated the safety and efficacy of overnight wear of PROSE devices in the treatment of refractory persistent epithelial defect (PED).

1Department of Ophthalmology Ocular Surface Center Bascom Palmer Eye Institute Miami, Florida

2Department Microbiology and Immunology University of Miami Miller School of Medicine Miami, Florida *

Submitted: March 31, 2017

Accepted: September 17, 2017

Funding/Support: None of the authors have reported funding/support.

Conflict of Interest Disclosure: KED—consultant for Alcon, Allergan, Abbott Medical Optics, Allergan, Omeros, TearLab, SUN, Shire; VLP—consultant for TearScience, Allergan, Bausch + Lomb, Eleven, Parion, EyeGate, Rigel, Aldyra, and RPS.

Author Contributions: Conceptualization: KD, VP, PS; Data Curation: XH, PS; Formal Analysis: XH; Methodology: PS; Supervision: KD, VP; Writing—Original Draft: XH; Writing—Review & Editing: XH, KD, PS.

© 2018 American Academy of Optometry