Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lens for Salzmann's nodular degeneration

Purpose: To evaluate the use of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lens treatment as an alternative to keratectomy in patients with symptomatic Salzmann's nodular degeneration (SND). Methods: A retrospective chart review from July 2009 to May 2013 identified 9 SND patients who were referred for PROSE evaluation. Patients who did not complete PROSE fitting or had other corneal comorbidities affecting vision were excluded from the study, and 7 eyes of 4 patients were included. Three patients were pseudophakic and 1 patient was phakic, and the lens status of our cohort did not change during the study. Results: Visual acuity improved from 0.19 +/- 0.084 logMAR (approximately 20/31) pre PROSE to 0.028 +/- 0.047 logMAR (approximately 20/21) post PROSE in patients with Salzmann's nodular degeneration (p = 0.002). OSDI scores improved from 46.9 +/- 26.6 pre PROSE to 21.5 +/- 18.7 post PROSE in the same cohort (p = 0.02). Conclusion: The results of this study show that PROSE can provide improvements in visual acuity and function in patients with Salzmann's nodular degeneration and offer an alternative to superficial keratectomy.