PROSE Treatments Associated With Improved Visual Functioning, Ocular Symptoms

Mini-scleral contact lens
Contact lens designs are classified as scleral lenses when there is full bearing on the sclera, further distinctions of the scleral lens group include mini-scleral and large-scleral lenses. These distinctions emphasize differences in central corneal clearance and other fitting characteristics. A lens that is 6mm larger than the visible iris diameter is classified as a mini-scleral lens.
Researchers observe no significant associations between ocular surface disease index scores and age, sex, mental illness, or PROSE device diameter, wear time, or extent of wear, according to a report.

Prosthetic replacement of the ocular surface ecosystem (PROSE) treatments improve visual function and relieve ocular symptoms, as measured by the Ocular Surface Disease Index (OSDI), according to a study published in Clinical Optometry. Secondary findings revealed that sex, age, preexisting mental illness, device diameter, average wear time, and duration of wear had no statistically significant impact on OSDI outcomes.

Researchers assessed 134 patients aged 18 or older and administered OSDI surveys at baseline, with 43 patients completing follow-up OSDI surveys. All patients were evaluated by the same clinician. Patients presented with a variety of ocular symptoms indicating PROSE, the 2 most common being keratoconjunctivitis sicca (KCS) (n=27) and corneal ectasia (n=16). Researchers also assessed the covariates of sex, age, device diameter, and average wear time.

Mean baseline OSDI score was 56.9±23.7 for the 43 eligible participants, and mean follow-up OSDI score was 23.8±15.6, a statistically significant improvement of 27.6% from baseline.

All patients except for 2 exhibited improved OSDI scores. Researchers were unable to establish a correlation between age, sex, mental illness, device diameter, average wear time, or extent of PROSE wear (P =.80, P =.23, P =.48, P =.55, P =.84, and P =.23, respectively).

“Compared to other therapeutics used traditionally for the treatment of DED or KCS, PROSE treatment showed greater percentage improvement in OSDI outcomes,” according to the investigators. “Overall, the findings in this report support that PROSE treatment can be considered for a multitude of corneal and ocular surface diseases with the expectation of improved OSDI symptoms.”

Study limitations include a retrospective nature, single center design, confounding due to other ocular treatments administered during the course of the study, and a failure to assess tear-film quality and performance.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, or clinical research organizations. Please see the original reference for a full list of authors’ disclosures. 


Asghari B, Brocks D, Carrasquillo KG, Crowley E. OSDI outcomes based on patient demographic and wear patterns in prosthetic replacement of the ocular surface ecosystem. Clin Optom. Published online January 10, 2022. doi:10.2147/opto.s337920.