Pediatric Scleral Lenses: 21-Year Retrospective Review.

Purpose: Retrospective study to review scleral lens outcomes in the pediatric population over a 21-year period, at a single clinical center.

Results: A total of 209 pediatric eyes (108 males and 101 females), distributed between 97 right and 112 left eyes, of which 147 eyes had ocular surface disease and 62 eyes had irregular cornea/refractive conditions, were treated with scleral lenses over a 21-year period. The mean age at the time of treatment initiation was 10.

Utilizing PROSE as a Drug Delivery Device for Preservative-Free Cyclosporine 0.05% for the Treatment of Dry Eye Disease: A Pilot Study.

Purpose: To evaluate the tolerability of utilizing Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) as a drug delivery device for preservative-free cyclosporine 0.05% for the treatment of dry eye disease.

Patients And Methods: Fourteen current daily PROSE wearers were enrolled, with four screen failures and one subject that did not complete the study protocol due to burning and stinging.

Case report: Concomitant use of nightly vitamin A ointment with daily PROSE wear for ocular surface disease associated with chronic Stevens-Johnson syndrome.

Purpose: To describe a case of chronic ocular surface disease associated with Stevens-Johnson Syndrome (SJS) in which the addition of nightly topical ophthalmic preservative free vitamin A ointment to the daily use of a customized ocular surface prosthetic device (PROSE) appears to mitigate disease progression.

Observations: A 51-year-old female with SJS secondary to lamotrigine use presented for follow up evaluation. Ocular history was significant for acute SJS twenty-four years prior with chronic ocular surface sequelae predominantly affecting the left eye.

Analysis of Prosthetic Replacement of the Ocular Surface Ecosystem Anterior Surface Condition Using Noninvasive Keratograph Break-Up Time.

Objectives: Noninvasive keratograph break-up time (NIKBUT) was developed as an alternative to fluorescein-based measurements of tear break-up time and may have utility not only for the objective evaluation of tear film stability on the corneal surface but also on the surface of scleral and contacts lenses. We report on two cases that highlight the potential use of NIKBUT to provide objective prelens tear film stability data to evaluate the anterior surface of a customized ocular surface prosthetic devices (PD; PROSE, BostonSight, Needham, MA).

Methods: Case report and literature review.

Case report: Utilization of a scleral lens to mitigate exposure keratopathy and associated mental health decline.

Purpose: To report a case of acute exposure keratopathy with comorbid depression and improvement of both conditions with the use of a scleral lens (SL).

Observations: A 72-year-old male with a past ocular history significant for extensive basal cell carcinoma (BCC) excision of the right upper and lower eyelids presented for evaluation of exposure keratitis and consideration of a SL for the right eye. Examination was notable for post-surgical irregular lid margins with lagophthalmos, trichiasis and an Oxford Grade I staining of the central exposed cornea.

Early Postoperative Therapeutic Scleral Lens Intervention for Penetrating Keratoplasty Complications in Atopic Keratoconjunctivitis.

A 52-year-old white man with keratoconus and severe atopic keratoconjunctivitis underwent penetrating keratoplasty (PK) for visual rehabilitation in the left eye. Post-PK complications included a persistent epithelial defect. Therapeutic scleral lens wear was initiated 2 weeks post-PK.

Treatment and Management of Ectrodactyly-Ectodermal Dysplasia-Clefting Syndrome With Scleral Prosthetic Devices.

This case report highlights the unique application and long-term benefits of customized scleral devices in a patient with ocular complications from ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome over the span of 10 years. A 13-year-old girl with a history of EEC syndrome and ocular manifestations, including severe bilateral dry eye disease, corneal neovascularization and scarring, progressive fibrous pannus, and limbal stem cell deficiency, was examined and fitted with scleral devices. The goal of treatment was to stabilize the ocular surface, enhance vision, and improve ocular comfort.

Case report: Utilization of neutral density filters for densitometry analysis of dense corneal opacities.

Purpose: This report describes the technique of utilizing a neutral density filter (NDF) during Scheimpflug imaging of a dense corneal opacity in order to increase data acquisition success and improve data reliability for densitometry analysis.

Observations: A 49-year-old female with Steven-Johnson Syndrome secondary to sulfonamide use presented for routine follow up evaluation of her customized ocular surface prosthetic device (PD). Her ocular history was significant for mucous membrane grafting and limbal stem cell transplant in both eyes.

Ocular Graft-versus-Host Disease Underdiagnosis: A Survey Study.

Purpose: To understand the degree and explore the possible causes of ocular graft-versus-host disease (oGVHD) underdiagnosis in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Patients And Methods: A 15-question survey was emailed to 6032 subscribers to the Blood and Marrow Transplant Information Network. A total of 371 respondents confirmed the history of allo-HSCT, of which 335 were symptomatic.

Case Report: Novel Patient Training Technique for the Application and Removal of Scleral Lenses.

Significance: This report shares a technique that can be used to assist training patients to properly and safely apply and remove prosthetic replacement of the ocular surface ecosystem devices (PD) or scleral lenses to reduce patient training nervousness, limit adverse events from training, and limit training failures.

Purpose: This study aimed to introduce a novel scleral lens application and removal training method.

Case Report: A 28-year-old woman with limbal stem cell deficiency secondary to contact lens overwear in the left eye greater than the right eye presented for prosthetic replacement of the ocular surface ecosystem treatment.

OSDI Outcomes Based on Patient Demographic and Wear Patterns in Prosthetic Replacement of the Ocular Surface Ecosystem.

Purpose: To evaluate the impact of prosthetic replacement of the ocular surface ecosystem (BostonSight PROSE) treatment on symptom outcomes based on the Ocular Surface Disease Index (OSDI).

Patients And Methods: This was a single-center, retrospective analysis of consecutive patients who initiated PROSE treatment between September 2017 and December 2019 by the same clinician. The primary outcome measure was to compare OSDI survey scores at baseline prior to PROSE treatment and at follow-up, after PROSE treatment.

Scleral Tonometry Precision During Scleral Lens Wear: A Pilot Study.

Purpose: To evaluate the reproducibility, and therefore the utility, of using traditional tonometry devices for measuring intraocular pressure (IOP), while a prosthetic replacement of the ocular surface ecosystem device (PD) or scleral lens is applied to the eye.

Patients And Methods: Twenty subjects (40 eyes) with keratoconus were enrolled. With PD applied, the first 10 consecutive patients had IOP measured multiple times with a handheld tonometer (Tono-Pen AVIA, Reichert, Depew, NY) on the superotemporal sclera 1 mm posterior to the PD edge.

Scleral Lens and Prosthetic Replacement of the Ocular Surface Ecosystem Utilization in Ocular Graft-versus-Host Disease: A Survey Study.

Purpose: To evaluate the utilization of scleral lenses and prosthetic replacement of the ocular surface ecosystem devices (SL/PDs) in the management of ocular graft-versus-host disease (oGVHD).

Patients And Methods: A survey of 15 questions was sent via email to 6032 subjects registered with the Blood and Marrow Transplant Information Network. The survey reviewed transplant history, graft-versus-host disease history, as well as oGVHD symptoms and onset.

Case Report: Use of Prosthetic Replacement of the Ocular Surface Ecosystem Treatment of Traumatic Lid Ptosis in a Pediatric Patient.

Significance: This report shares the long-term outcomes of an uncommon use of prosthetic replacement of the ocular surface ecosystem (PROSE) treatment and scleral lenses in the treatment for patients with ptosis who are not surgical candidates.

Purpose: This study aimed to describe a case of pediatric traumatic lid ptosis and follow-up during an 8-year period with PROSE treatment.

Case Report: A 7-year-old Honduran girl presented with a history of severe cranial, facial, and ocular trauma as a result of a motor vehicle accident.

Self-Retained Cryopreserved Amniotic Membrane for the Management of Corneal Ulcers.

Purpose: To evaluate the clinical outcomes of self-retained cryopreserved amniotic membrane (cAM) for the treatment of corneal ulcers.

Methods: This was a single-center, retrospective review of consecutive patients with non-healing corneal ulcers that underwent treatment with self-retained cAM (PROKERA Slim). The primary outcome measure was time to complete corneal epithelialization.

Videokeratography in conductive keratoplasty.

Purpose: We used EyeSys videokeratography to evaluate corneal shape changes induced by conductive keratoplasty, a procedure that utilizes radio frequency energy to alter corneal shape to correct hyperopia.

Methods: Follow-up data were available for 19 eyes (out of 24 eyes of 13 patients). Preoperative spherical hyperopia ranged from +0.

Calpain regulates enterocyte brush border actin assembly and pathogenic Escherichia coli-mediated effacement.

This study identifies calpain as being instrumental for brush border (BB) microvillus assembly during differentiation and effacement during bacterial pathogenesis. Calpain activity is decreased by 25-80% in Caco 2 lines stably overexpressing calpastatin, the physiological inhibitor of calpain, and the effect is proportional to the calpastatin/calpain ratio. These lines exhibit a 2.