Case series: Extended wear of rigid gas permeable scleral contact lenses for the treatment of persistent corneal epithelial defects

Khan, Mahmood; Manuel, Keith; Vegas, Brooke; Yadav, Shikha; Hemmati, Roxana T; Al-Mohtaseb, Zaina

doi:10.1016/j.clae.2018.09.004

Cited by 16 publications

(13 citation statements)

References 14 publications

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“…Although the right eye of patient 4 illustrated a successful case of improved vision in a patient with TMD postcorneal graft, the underlying LSCD in her left eye continued to progress to the point of requiring a limbal stem-cell transplant. Although PROSE helps to maintain ocular surface hydration and promotes corneal epithelial healing, 19 it does not necessarily definitively halt progression of conditions such as LSCD. Accordingly, routine follow-up with the ophthalmologist is essential to determine whether further interventions are necessary.…”

Section: Discussionmentioning

confidence: 99%

Prosthetic Replacement of the Ocular Surface Ecosystem for Terrien Marginal Degeneration: A Case Series

Wong

Trinh

Garg

et al. 2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objectives: To assess outcomes of the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment in patients with advanced Terrien marginal degeneration (TMD). Methods: This is a retrospective case series of patients with advanced TMD who were assessed and fit with customized PROSE lenses. Data were collected on PROSE fitting details including visual acuity (VA) before and after PROSE, slit-lamp findings, and corneal tomography scans. Results: Six eyes in four patients were included. All patients attempted at least one other contact lens (CL) modality before PROSE. Some patients had corneal comorbidities such as pseudopterygium and pseudobleb that contributed to intolerance to previous lenses and warranted extra considerations in the fitting process. With PROSE, VA improved in all six eyes. Patients with structural corneal comorbidities achieved improved vision, comfort, and lens tolerance with PROSE. Two eyes had noncorneal ocular comorbidities that limited PROSE efficacy. Another eye discontinued PROSE wear because of limbal stem-cell disease progression necessitating a limbal stem-cell transplant. Conclusions: PROSE treatment can be an effective option to improve vision and comfort for patients with advanced TMD who are intolerant to first-line therapeutic CL modalities, even in the presence of other corneal comorbidities.

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Section: Discussionmentioning

confidence: 99%

Prosthetic Replacement of the Ocular Surface Ecosystem for Terrien Marginal Degeneration: A Case Series

Wong

Trinh

Garg

et al. 2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…In our study population, as well as in the literature, first line therapies included lubrication, reduction of the topical treatment to the ones strictly needed with the choice of preservative free topical eyedrops, BCL, punctal occlusion, and less frequently temporary tarsorrhaphy, botulinum toxin A injection, AMT and autologous serum tears. 5,[24][25][26][27][28] The use of topical corticosteroids in our study population has been explained above and was mainly linked to the underlying pathology for each patient. We believe our findings raise the question as to whether female patients should receive more aggressive treatment options at baseline to help shorten the disease duration.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for corneal epithelial wound healing: Can sex play a role?

Coco

Hamill

Troughton

et al. 2021

European Journal of Ophthalmology

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Purpose To determine if sex is associated with corneal epithelial wound healing time in patients with persistent corneal epithelial defects (PCEDs). Methods Retrospective case series on patients with PCED from November 2014 to January 2019. Records of 127 patients with diagnosis of PCED were reviewed. Patients with an epithelial defect that lasted more than two weeks in the absence of an active corneal infection were included. Main outcome was corneal epithelial wound healing time. Results 55 patients (29 males) with a mean age of 65.3 ± 16.5 years were included. No difference was found between female and male patients in terms of risk factors, age, treatment strategies or intervals between visits (median of 15 days in females and 12 days in males; p = 0.24). Median duration of the PCED was 51 days (IQR 32-130), with a median number of 5 clinical visits (IQR 4-8). Female patients had significantly longer healing times (p = 0.004) and a corresponding increase in the number of clinical visits (median of 7 visits vs. 5 clinical visits in males, p = 0.012). Conclusion Results from this study suggest female patients with PCED might have a longer corneal epithelial wound healing duration and may therefore require earlier intervention.

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“…Unlike the prior study, most eyes had complete re-epithelialisation with no adverse events with the prophylactic antibiotic treatment. Other studies report success with the PROSE device for the treatment of PEDs and recurrent corneal erosion syndrome secondary to multiple aetiologies [149][150][151]. Interestingly, in one study, all were patients that had failed to heal with wear of a silicone hydrogel BSCL [149].…”

Section: Persistent Epithelial Defects (Ped)mentioning

confidence: 99%

BCLA CLEAR – Medical use of contact lenses

Jacobs

Carrasquillo²,

Cottrell

et al. 2021

Contact Lens and Anterior Eye

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The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for such applications. There is consistent evidence that bandage soft contact lenses, particularly silicone hydrogel lenses, improve epithelial healing and reduce pain in persistent epithelial defects, after trauma or surgery, and in corneal dystrophies. Drug delivery applications of contact lens hold promise for improving topical therapy. Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment. This report offers a practical and relevant summary of the current evidence for the medical use of contact lenses for all eye care professionals including optometrists, ophthalmologists, opticians, and orthoptists. Topics covered include indications for use in both acute and chronic conditions, lens selection, patient selection, wear and care regimens, and recommended aftercare schedules. Prevention, presentation, and management of complications of medical use are reviewed.

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Case series: Extended wear of rigid gas permeable scleral contact lenses for the treatment of persistent corneal epithelial defects

Cited by 16 publications

References 14 publications

Prosthetic Replacement of the Ocular Surface Ecosystem for Terrien Marginal Degeneration: A Case Series

Prosthetic Replacement of the Ocular Surface Ecosystem for Terrien Marginal Degeneration: A Case Series

Risk factors for corneal epithelial wound healing: Can sex play a role?

BCLA CLEAR – Medical use of contact lenses

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