The Dry Eye Zone

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Abstract: Using PROSE for lagophthalmos and exposure keratitis


Prosthetic replacement of the ocular surface ecosystem is a treatment developed by the Boston Foundation for Sight that uses a Food and Drug Administration-approved prosthetic device for the treatment of severe ocular surface disease to improve vision and discomfort in addition to supporting the ocular surface. Facial nerve paralysis has multiple causes including trauma, surgery, tumor, stroke, and congenital lagophthalmos. Subsequent lagophthalmos leading to exposure keratitis has been treated with copious lubrication, tarsorrhapy, eyelid weights, chemodenervation to yield protective ptosis, and palpebral spring insertion. Each of these treatments, however, has limitations and potential complications. The prosthetic replacement of the ocular surface ecosystem device provides a liquid bandage to protect the cornea from eyelid interaction and dessication in addition to improving vision. This report describes 4 patients with exposure keratitis who were successfully treated with prosthetic replacement of the ocular surface ecosystem devices at 2 clinical sites.

Ophthal Plast Reconstr Surg. 2012 Oct 3. [Epub ahead of print]
Gire A, Kwok A, Marx DP.
*Alkek Eye Center, Baylor College of Medicine, Houston, Texas; and †Boston Foundation for Sight, Needham, Massachusetts, U.S.A.

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