A recent study has made the case for considering the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral device before surgical options for the visual rehabilitation of patients with limbal stem cell deficiency (LSCD). Researchers found that using the large, customizable, gas permeable scleral device improved patients’ corneal epithelial defects and provided long-term ocular surface improvements.

The researchers reviewed the charts of 31 eyes of 19 consecutive patients clinically diagnosed with LSCD who were evaluated for the PROSE device. Corrected distance visual acuity improved from 0.86±0.50 logMAR at baseline to 0.46±0.44 logMAR with PROSE at the last follow-up (mean, 25.1±18.0 months). In 27 eyes, corrected-distance visual acuity improved, with 22 eyes gaining two or more lines of Snellen acuity.

The study suggests that the PROSE device is beneficial because vaults the cornea and limbus, bathing the ocular surface and maximizing the function of the remaining stem cells while also neutralizing the irregular surface.

“We hypothesize that this device may help to restore the limbal niche and circumvent additional damage to the remaining limbal stem cells,” the study’s authors wrote. Still, the researchers advise not to generalize their results more broadly to other scleral lenses until further study confirms their safety and efficacy in LSCD treatment.

Kim KH, Deloss KS, Hood CT. Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) for visual rehabilitation in limbal stem cell deficiency. Eye Contact Lens. February 24, 2020. [Epub ahead of print].