The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Gloria B Chiu - One of the best experts on this subject based on the ideXlab platform.
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prosthetic replacement of the ocular surface ecosystem scleral lens therapy for exposure keratopathy
Eye & Contact Lens-science and Clinical Practice, 2017Co-Authors: Jasdeep S Chahal, Martin Heur, Gloria B ChiuAbstract:Objectives To investigate the utility of Prosthetic Replacement of the Ocular Surface Ecosystem (Prose) scleral lenses in patients with exposure keratopathy, with outcomes based on changes in visual acuity, visual function, and corneal staining. Methods A retrospective interventional case series of patients evaluated and treated from September 2009 through June 2014 at a single multi-specialty institutional practice. Eighteen of 29 patients with exposure keratoconjunctivitis, lagophthalmos, ectropion, or lid retraction, referred to USC Eye Institute after failing conventional therapies completed Prose scleral lens fitting and were included in the study. Visual function was assessed before and after Prose fitting with the Ocular Surface Disease Index (OSDI) survey. Visual acuity (VA) and corneal staining changes were also evaluated before and after treatment. Results Visual acuity improved from 0.60±0.68 logMAR pre-Prose to 0.25±0.34 logMAR (Z=-3.81, P=0.00014) post-Prose, which corresponds to an improvement of about 20/80 to 20/35 on Snellen VA. Ocular Surface Disease Index scores improved from 56.54±29.75 pre-Prose to 24.98±21.23 post-Prose (Z=-2.98, P=0.0029), and corneal staining values decreased from 2.17±0.84 pre-Prose to 0.64±0.70 post-Prose (Z=-3.27, P=0.011). Conclusions The results suggest that Prose scleral lens therapy is effective in patients with exposure keratopathy who had failed conventional therapies and can serve as an alternative to lid surgery.
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glaucoma surgical considerations for Prose lens use in patients with ocular surface disease
Contact Lens and Anterior Eye, 2016Co-Authors: Anhtuan Nguyen, Gloria B Chiu, Anna Dastiridou, Olivia L Lee, Brian A Francis, Vikas ChopraAbstract:Abstract Purpose To examine challenges of Prosthetic Replacement of the Ocular Surface Ecosystem (Prose) treatment in patients with glaucoma drainage implants (GDI) and the surgical management of patients where both GDI and Prose treatment are indicated. Methods A retrospective noncomparative observational study was performed to investigate the outcomes of 7 eyes of 6 patients that required Prose lens wear and GDI implantation. Results Group A consisted of 2 cases where Prose lens wear was problematic due to scleral surface irregularities following GDI placement. These included changes in surface morphology caused by the elevated scleral patch graft tissue adjacent to the corneal limbus in one case and the presence of two anteriorly located shunts in the other. Group B consisted of 3 eyes where the previously placed GDI led to poor lens alignment due to the proximity of the lens edge to the scleral graft. Group C consisted of 2 cases where both patients underwent placement of the GDI in the pars plana and insertion of the drainage tube 3–3.5 mm from the limbus in order to facilitate Prose lens use. The posterior location of the tube and patch allowed for proper Prose device alignment over the ocular surface. Conclusions Surgical considerations and prior planning for GDI placement allows Prose lens use for management of ocular surface disease. Pars plana tube placement with a posteriorly placed patch graft, instead of anterior chamber tube positioning with more anterior graft, enables adequate lens wear in scleral-lens-dependent patients.
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prosthetic replacement of the ocular surface ecosystem scleral lens therapy for patients with ocular symptoms of chronic stevens johnson syndrome
American Journal of Ophthalmology, 2014Co-Authors: Martin Heur, Dianne Bach, Christos Theophanous, Gloria B ChiuAbstract:Purpose To evaluate the results of Prosthetic Replacement of the Ocular Surface Ecosystem (Prose) scleral lens treatment on visual acuity and function in patients with ocular symptoms of chronic Stevens-Johnson syndrome (SJS). Design Retrospective interventional case series. Methods setting: Single multi-specialty institutional practice. study population: A chart review from July 2009 to July 2013 identified 19 patients with ocular symptoms from chronic SJS who were referred for Prose fitting evaluation. Three patients deemed appropriate candidates were excluded because they were lost to follow-up during the fitting process. Only 1 eye was fitted in 4 patients because anatomic changes prohibited Prose fitting in the fellow eye. Another patient chose to have Prose fitting only in 1 eye. A total of 27 eyes of 16 patients who completed Prose fitting were included in this study. intervention: Prose scleral lens fitting. outcome measures: Visual acuity and visual function were assessed before and after Prose fitting using Snellen acuity and Ocular Surface Disease Index (OSDI) survey. The OSDI survey is a validated questionnaire that assesses ocular surface disease in the context of vision-related function, ocular symptoms, and environmental triggers. Results Visual acuity improved from 0.43 ± 0.35 logMAR pre-Prose to 0.14 ± 0.22 logMAR post-Prose ( P = .0007) in SJS patients. OSDI scores improved from 70.4 ± 19.0 pre-Prose to 37.4 ± 23.2 post-Prose ( P = .0002) in the same cohort. Conclusion The results of this study show that Prose treatment is a viable option for improving visual acuity and function in SJS patients who failed conventional treatment.
Stephen C Pflugfelder - One of the best experts on this subject based on the ideXlab platform.
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assessment of the prosthetic replacement of ocular surface ecosystem Prose scleral lens on visual acuity for corneal irregularity and ocular surface disease
Ocular Surface, 2018Co-Authors: Andres S Parra, Stephen C Pflugfelder, Bryan M Roth, Taylor M Nguyen, Li Wang, Zaina AlmohtasebAbstract:Abstract Purpose To describe changes in visual acuity in patients fit with the Prosthetic Replacement of Ocular Surface Ecosystem (Prose) with irregular corneas compared to those with ocular surface disease, as well as describe patient demographics and fitting indications for Prose at an academic medical center. Methods A retrospective chart review from 2010 to 2016 on a total of 825 eyes from 493 patients fitted with a Prose lens, and grouped by etiology, either irregular cornea/dystrophy or ocular surface disease and associated sub-etiologies. We compared best corrected visual acuity (BCVA) before and after Prose fitting. Results The irregular cornea group (n = 262 eyes) included corneal scar (n = 57), dystrophy (n = 17), post-operative corneal irregularity (n = 70), and primary ectasia (n = 118). The OSD group included 563 eyes. For all etiologies combined, mean BCVA prior to Prose fitting compared to after improved by 0.28 logMAR (p Conclusions Prose treatment had a positive impact on visual acuity for a wide range of corneal irregularities and ocular surface disease, suggesting that Prose lenses may offer improvements in visual acuity without risks inherent to surgery.
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patient ocular conditions and clinical outcomes using a Prose scleral device
Contact Lens and Anterior Eye, 2013Co-Authors: Ryan Dimit, Stephen C Pflugfelder, Anisa Gire, Jan P G BergmansonAbstract:Abstract Purpose To determine the type and distribution of ocular conditions cared for in a clinic dedicated to scleral devices and to report the clinical outcomes afforded by this approach. Methods Fifty-one charts of patients fitted unilaterally or bilaterally with a scleral device (Prosthetic Replacement of the Ocular Surface Ecosystem – Prose) in a two year period were retrospectively reviewed. Patient demographics, ocular diagnoses, associated systemic conditions, best corrected visual acuity (BCVA) before and after fitting, Visual Function Questionnaire score (VFQ-25), and ocular surface disease index (OSDI) score were collected. Results All 51 patients were successfully wearing the Prose device for a period of anywhere from weeks to years. The most common reasons for fitting were to relieve symptoms of moderate to severe dry eye syndrome (“DES”, n = 25), management of refractive problems (“refractive”, n = 23) with keratoconus being the most common ( n = 14), and to manage other anomalies (“other”, n = 3). Best corrected visual acuity (logMAR) improved with the wearing of the Prose device for both the DES (17 letters) and the refractive group (10 letters), but not the “other” group. No serious complications were recorded for any of the patients. Conclusions The Prose device is a useful option not only for the management of ocular surface disease and optical imperfections, but also for other ophthalmic conditions. Moderate to severe dry eye was the most common anomaly managed, followed by eyes with irregular corneal astigmatism. DES and refractive patients experienced improvement in visual acuity with wearing of the Prose device.
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Prose therapy used to minimize corneal trauma in patients with corneal epithelial defects
American Journal of Ophthalmology, 2013Co-Authors: Jeanie D Ling, Anisa Gire, Stephen C PflugfelderAbstract:Purpose To review the effectiveness of continuous or extended daily wear of Prosthetic Replacement of the Ocular Surface Ecosystem (Prose) for treating recurrent or persistent corneal epithelial defects from a variety of causes that were refractory to conventional therapy in 9 patients. Design Retrospective case series. Methods The medical records of 9 patients with a history of recurrent or persistent corneal epithelial defects resistant to conventional medical treatment who received treatment at the Cullen Eye Institute between January 2011 and July 2012 were reviewed. Demographic information, etiology, prior treatment, and outcome of Prose treatment were analyzed. Recurrence after cessation of Prose and complications were also identified. Results The etiologies of recurrent or persistent corneal epithelial defects in this series included neurotrophic keratopathy, lattice and Avellino dystrophy, Stevens-Johnson syndrome, and chemical/thermal injury. All patients were initially treated with bandage contact lens; however, continuous silicone hydrogel lens wear was not effective in preventing recurrence or healing corneal epithelial defects in all patients. Epithelial defects healed without recurrence in all 9 patients treated with Prose. Eight patients developed recurrent epithelial defects when Prose was discontinued, but rehealed after resuming Prose. Visual acuity improved in 8 patients (88.9%) treated with Prose. Conclusions Complex persistent or recurrent corneal epithelial defects that failed to heal with extended silicone hydrogel contact lenses healed with Prose. Prose therapy was well tolerated, but corneal epithelial defects recurred in all but 1 case following cessation of therapy.
Christopher T Hood - One of the best experts on this subject based on the ideXlab platform.
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prosthetic replacement of the ocular surface ecosystem Prose for visual rehabilitation in limbal stem cell deficiency
Eye & Contact Lens-science and Clinical Practice, 2020Co-Authors: Kyeong Hwan Kim, Karen S Deloss, Christopher T HoodAbstract:OBJECTIVES To evaluate the clinical outcomes of patients with limbal stem cell deficiency (LSCD) who were fitted with the Prosthetic Replacement of the Ocular Surface Ecosystem (Prose) scleral device. METHODS In this retrospective, interventional case series, we reviewed the charts of 31 eyes of 19 consecutive patients clinically diagnosed with LSCD who were evaluated for the Prose device. Clinical data were reviewed before Prose evaluation and at the last available follow-up. The main outcomes measures were best-corrected distance visual acuity (CDVA) and modified ocular involvement score (OIS), graded using a previously described system for corneal findings. RESULTS Corrected distance visual acuity improved from 0.86±0.50 logarithm of the minimal angle of resolution (Snellen equivalent, 20/145) at baseline to 0.46±0.44 (Snellen equivalent, 20/58) with Prose at the last follow-up (mean, 25.1±18.0 months; P<0.0001). In 27 eyes (87.1%) CDVA improved, with 22 eyes (71.0%) gaining 2 or more lines of Snellen acuity. When categorized by disease severity, CDVA improved in less severe eyes (stage 1) and more severe eyes (stage 2 or 3; P=0.049 and P=0.00009, respectively). Total OIS was not significantly different between baseline and last follow-up (P=0.754); however the epithelial defect score was significantly less (P=0.034). Twenty-four of 31 eyes (77.4%) continued wearing the Prose device, with a mean daily wearing time of 10.0±4.6 hrs. CONCLUSIONS In patients with LSCD, vision improved and the OIS remained stable with Prose, suggesting that the device could be considered for visual rehabilitation in this population.
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prosthetic replacement of the ocular surface ecosystem Prose scleral device compared to keratoplasty for the treatment of corneal ectasia
American Journal of Ophthalmology, 2014Co-Authors: Karen S Deloss, Nadeem Fatteh, Christopher T HoodAbstract:Purpose To compare the ocular characteristics and visual outcomes of eyes with corneal ectasia that were fitted with the Prosthetic Replacement of the Ocular Surface Ecosystem (Prose) scleral device to those that underwent keratoplasty. Design Retrospective, comparative case series. Methods We reviewed the charts of consecutive patients with corneal ectasia that were evaluated for Prose or underwent keratoplasty at our institution. Clinical data, topographic indices, and corneal thickness were reviewed, and eyes were stratified according to the Amsler-Krumeich classification for severity of ectasia. Only the more severe eye of each patient was included in the study. We compared visual acuity before and after Prose fitting or keratoplasty. For Prose evaluations, achievement of satisfactory fit and continued wear at 1 year of follow-up were recorded. Results From 2010 to 2012, 36 patients underwent Prose evaluation for corneal ectasia while 37 patients underwent keratoplasty for the same indication. All eyes were successfully fitted with the Prose device. Eyes in the keratoplasty group had more severe ectasia than eyes in the Prose group ( P = .038). Visual acuity was achieved more rapidly in the Prose cohort compared to keratoplasty, and mean visual acuity was significantly better for all eyes ( P P P = .003). At 1 year follow-up in the Prose cohort, Snellen acuity was 20/28 ( P = .108 vs keratoplasty), improving to 20/25 with over-refraction ( P = .006 vs keratoplasty). Conclusions Eyes with advanced corneal ectasia can be successfully fitted with the Prose device, and the visual acuity outcome for stage 4 ectasia was better and more rapid compared to keratoplasty. The acuity remained excellent with 1 year of follow-up. Prose evaluation should be considered in patients with advanced corneal ectasia before proceeding to keratoplasty, especially if the ectasia is deemed stable.
Zaina Almohtaseb - One of the best experts on this subject based on the ideXlab platform.
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assessment of the prosthetic replacement of ocular surface ecosystem Prose scleral lens on visual acuity for corneal irregularity and ocular surface disease
Ocular Surface, 2018Co-Authors: Andres S Parra, Stephen C Pflugfelder, Bryan M Roth, Taylor M Nguyen, Li Wang, Zaina AlmohtasebAbstract:Abstract Purpose To describe changes in visual acuity in patients fit with the Prosthetic Replacement of Ocular Surface Ecosystem (Prose) with irregular corneas compared to those with ocular surface disease, as well as describe patient demographics and fitting indications for Prose at an academic medical center. Methods A retrospective chart review from 2010 to 2016 on a total of 825 eyes from 493 patients fitted with a Prose lens, and grouped by etiology, either irregular cornea/dystrophy or ocular surface disease and associated sub-etiologies. We compared best corrected visual acuity (BCVA) before and after Prose fitting. Results The irregular cornea group (n = 262 eyes) included corneal scar (n = 57), dystrophy (n = 17), post-operative corneal irregularity (n = 70), and primary ectasia (n = 118). The OSD group included 563 eyes. For all etiologies combined, mean BCVA prior to Prose fitting compared to after improved by 0.28 logMAR (p Conclusions Prose treatment had a positive impact on visual acuity for a wide range of corneal irregularities and ocular surface disease, suggesting that Prose lenses may offer improvements in visual acuity without risks inherent to surgery.
Martin Heur - One of the best experts on this subject based on the ideXlab platform.
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prosthetic replacement of the ocular surface ecosystem scleral lens therapy for exposure keratopathy
Eye & Contact Lens-science and Clinical Practice, 2017Co-Authors: Jasdeep S Chahal, Martin Heur, Gloria B ChiuAbstract:Objectives To investigate the utility of Prosthetic Replacement of the Ocular Surface Ecosystem (Prose) scleral lenses in patients with exposure keratopathy, with outcomes based on changes in visual acuity, visual function, and corneal staining. Methods A retrospective interventional case series of patients evaluated and treated from September 2009 through June 2014 at a single multi-specialty institutional practice. Eighteen of 29 patients with exposure keratoconjunctivitis, lagophthalmos, ectropion, or lid retraction, referred to USC Eye Institute after failing conventional therapies completed Prose scleral lens fitting and were included in the study. Visual function was assessed before and after Prose fitting with the Ocular Surface Disease Index (OSDI) survey. Visual acuity (VA) and corneal staining changes were also evaluated before and after treatment. Results Visual acuity improved from 0.60±0.68 logMAR pre-Prose to 0.25±0.34 logMAR (Z=-3.81, P=0.00014) post-Prose, which corresponds to an improvement of about 20/80 to 20/35 on Snellen VA. Ocular Surface Disease Index scores improved from 56.54±29.75 pre-Prose to 24.98±21.23 post-Prose (Z=-2.98, P=0.0029), and corneal staining values decreased from 2.17±0.84 pre-Prose to 0.64±0.70 post-Prose (Z=-3.27, P=0.011). Conclusions The results suggest that Prose scleral lens therapy is effective in patients with exposure keratopathy who had failed conventional therapies and can serve as an alternative to lid surgery.
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prosthetic replacement of the ocular surface ecosystem scleral lens therapy for patients with ocular symptoms of chronic stevens johnson syndrome
American Journal of Ophthalmology, 2014Co-Authors: Martin Heur, Dianne Bach, Christos Theophanous, Gloria B ChiuAbstract:Purpose To evaluate the results of Prosthetic Replacement of the Ocular Surface Ecosystem (Prose) scleral lens treatment on visual acuity and function in patients with ocular symptoms of chronic Stevens-Johnson syndrome (SJS). Design Retrospective interventional case series. Methods setting: Single multi-specialty institutional practice. study population: A chart review from July 2009 to July 2013 identified 19 patients with ocular symptoms from chronic SJS who were referred for Prose fitting evaluation. Three patients deemed appropriate candidates were excluded because they were lost to follow-up during the fitting process. Only 1 eye was fitted in 4 patients because anatomic changes prohibited Prose fitting in the fellow eye. Another patient chose to have Prose fitting only in 1 eye. A total of 27 eyes of 16 patients who completed Prose fitting were included in this study. intervention: Prose scleral lens fitting. outcome measures: Visual acuity and visual function were assessed before and after Prose fitting using Snellen acuity and Ocular Surface Disease Index (OSDI) survey. The OSDI survey is a validated questionnaire that assesses ocular surface disease in the context of vision-related function, ocular symptoms, and environmental triggers. Results Visual acuity improved from 0.43 ± 0.35 logMAR pre-Prose to 0.14 ± 0.22 logMAR post-Prose ( P = .0007) in SJS patients. OSDI scores improved from 70.4 ± 19.0 pre-Prose to 37.4 ± 23.2 post-Prose ( P = .0002) in the same cohort. Conclusion The results of this study show that Prose treatment is a viable option for improving visual acuity and function in SJS patients who failed conventional treatment.
