Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lens for Salzmann’s nodular degeneration

Abstract

PurposeTo evaluate the use of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lens treatment as an alternative to keratectomy in patients with symptomatic Salzmann’s nodular degeneration (SND). MethodsA retrospective chart review from July 2009 to May 2013 identified 9 SND patients who were referred for PROSE evaluation. Patients who did not complete PROSE fitting or had other corneal comorbidities affecting vision were excluded from the study, and 7 eyes of 4 patients were included. Three patients were pseudophakic and 1 patient was phakic, and the lens status of our cohort did not change during the study. ResultsVisual acuity improved from 0.19±0.084 logMAR (approximately 20/31) pre PROSE to 0.028±0.047 logMAR (approximately 20/21) post PROSE in patients with Salzmann’s nodular degeneration (p=0.002). OSDI scores improved from 46.9±26.6 pre PROSE to 21.5±18.7 post PROSE in the same cohort (p=0.02). ConclusionThe results of this study show that PROSE can provide improvements in visual acuity and function in patients with Salzmann’s nodular degeneration and offer an alternative to superficial keratectomy.