Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) Treatment for Complications After LASIK.

OBJECTIVES: To report experience with Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment for complications after laser in situ keratomileuisis (LASIK).

METHODS: Retrospective review of clinical and manufacturing records. A database of patients who underwent PROSE treatment from 1992 to 2007 was searched to yield all patients with history of LASIK. Primary indication for PROSE treatment and year of LASIK is reported as well as history of contact lens intolerance and pretreatment and posttreatment best-corrected visual acuity (BCVA).

RESULTS: From 1992 to 2007, 44 patients (75 eyes) with history of LASIK underwent PROSE treatment. Patients with corneal ectasia (n=23, 52%) comprise the largest group of patients, followed by those with other optical aberrations (n = 14.32%), dry eye (n = 4.9%), and corneal neuralgia (n=3.7%). Thirteen patients (30%) had more than one indication for PROSE treatment. The majority (71%) of patients referred for PROSE treatment had LASIK between 1998 and 2000, including every patient with aberrations as primary indication. Eighty-six percent of all patients had history of contact lens intolerance. Eighty-four percent of eyes showed improvement in BCVA after PROSE treatment, mean -0.3LogMAR, (P < 0.0001, 2-tailed paired t test, n = 75).

CONCLUSIONS: PROSE treatment is an effective option for management of ectasia, cornea first surface aberrations, dry eye, and corneal neuralgia after LASIK, even in patients who are contact lens intolerant.