Abstract：
OBJECTIVE: 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.
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.
摘要：
目的：评估晚期Terrien边缘变性（TMD）患者眼表生态系统假体置换（PROSE）治疗的结果。
方法：这是一个回顾性病例系列，对晚期TMD患者进行了定制PROSE镜片的评估和配戴。数据收集了PROSE拟合细节，包括PROSE前后的视力（VA），裂隙灯的发现，和角膜断层扫描。
结果：纳入4例患者的6只眼。所有患者在PROSE之前尝试了至少一种其他隐形眼镜（CL）模式。一些患者有角膜合并症，如假翼状胬肉和假球，这导致对以前的晶状体不耐受，在装配过程中需要额外考虑。有了PROSE,所有六只眼睛的VA均得到改善。结构性角膜合并症患者视力改善，comfort,和镜头公差与PROSE。两只眼睛有限制PROSE疗效的非角膜眼合并症。由于角膜缘干细胞疾病的进展，需要进行角膜缘干细胞移植，另一只眼睛停止了PROSE的佩戴。
结论：PROSE治疗对于不能耐受一线治疗CL模式的晚期TMD患者来说，是改善视力和舒适度的有效选择。即使存在其他角膜合并症。
方法：这是一个回顾性病例系列，对晚期TMD患者进行了定制PROSE镜片的评估和配戴。数据收集了PROSE拟合细节，包括PROSE前后的视力（VA），裂隙灯的发现，和角膜断层扫描。
结果：纳入4例患者的6只眼。所有患者在PROSE之前尝试了至少一种其他隐形眼镜（CL）模式。一些患者有角膜合并症，如假翼状胬肉和假球，这导致对以前的晶状体不耐受，在装配过程中需要额外考虑。有了PROSE,所有六只眼睛的VA均得到改善。结构性角膜合并症患者视力改善，comfort,和镜头公差与PROSE。两只眼睛有限制PROSE疗效的非角膜眼合并症。由于角膜缘干细胞疾病的进展，需要进行角膜缘干细胞移植，另一只眼睛停止了PROSE的佩戴。
结论：PROSE治疗对于不能耐受一线治疗CL模式的晚期TMD患者来说，是改善视力和舒适度的有效选择。即使存在其他角膜合并症。
