OSDI Outcomes Based on Patient Demographic and Wear Patterns in Prosthetic Replacement of the Ocular Surface Ecosystem

Abstract

Purpose: To evaluate the impact of prosthetic replacement of the ocular surface ecosystem (BostonSight PROSE) treatment on symptom outcomes based on the Ocular Surface Disease Index (OSDI). Patients and Methods: This was a single-center, retrospective analysis of consecutive patients who initiated PROSE treatment between September 2017 and December 2019 by the same clinician. The primary outcome measure was to compare OSDI survey scores at baseline prior to PROSE treatment and at follow-up, after PROSE treatment. Indication for treatment, sex, age, device diameter, average wear time, preexisting mental illness, duration of PROSE wear, and status of PROSE wear at follow-up were also studied. Results: A total of 134 patients underwent PROSE treatment and completed a baseline OSDI survey during the study period. Forty-three patients completed a follow-up OSDI survey and were included in the study analysis. The most common treatment indications were keratoconjunctivitis sicca (n=27) and corneal ectasia (n=16). Baseline average OSDI score was 56.9±23.7 for the 43 subjects who completed a subsequent OSDI survey. The last documented average follow-up OSDI for those 43 subjects was 23.8±15.6, median (IQR) of 22.9 (10.4 to 32.3), and a statistically significant 54.7±27.6% average improvement from baseline (p<0.01). All patients, except for two, showed improvement in OSDI score. Statistically significant improvement occurred regardless of underlying diagnosis with no statistically significant difference based on age, sex, mental illness, or device diameter and no statistical correlation with average wear time, or duration of PROSE wear. Conclusion: PROSE treatment improves visual function and symptom relief as demonstrated by the OSDI survey. Sex, age, preexisting mental illness, device diameter, average wear time, and duration of wear had no statistically significant impact on OSDI outcomes.

Treatment and Management of Ectrodactyly–Ectodermal Dysplasia–Clefting Syndrome With Scleral Prosthetic Devices

“…Scleral devices have been demonstrated to improve and stabilize visual acuity in patients with limbal stem cell deficiency 6,7 and shown to support the function of the corneal epithelium. [8][9][10] Even so, there is limited literature describing scleral device use in patients with ectodermal dysplasia. 1 There are various reports in the literature about sightthreatening ocular complications of EEC syndrome where pharmacological agents alone did not seem to prevent disease progression.…”

“…Notably, scleral devices were not presented as a potential treatment option in any of these cases. Although each case is unique and scleral lenses may not be suitable for all EEC syndrome cases, the reported benefits of scleral lenses in LSCD 6,7,9 and the effect these lenses have on the support of the ocular surface, [6][7][8][9][10] presumably they may have potentially played a positive role in the patients/cases reported above.…”

“…Scleral devices have been demonstrated to improve and stabilize visual acuity in patients with limbal stem cell deficiency 6,7 and shown to support the function of the corneal epithelium. 8–10 Even so, there is limited literature describing scleral device use in patients with ectodermal dysplasia. 1…”

Early Postoperative Therapeutic Scleral Lens Intervention for Penetrating Keratoplasty Complications in Atopic Keratoconjunctivitis

“…They can improve vision in patients with complex corneal geometry. 18,19 They can serve as an effective treatment for PED, averaging complete healing at 8 days. 20 In addition, the use of a scleral lens as a drug delivery system has been previously described.…”

Isotretinoin-Related Eye Dryness in Acne Patients in Qassim, Saudi Arabia

“…Our study's results are consistent with previous research that has examined the relationship between pre-existing symptoms and OSDI severity. For instance, Asghari et al (2022) [ 19 ] conducted a similar study and reported that patients with severe OSDI scores were more likely to have pre-existing symptoms compared to those with non-severe scores. This supports the notion that pre-existing symptoms play a role in the severity of OSDI scores, and our findings further highlight the impact of symptom worsening.…”