Case Series: Overnight Wear of Scleral Lens for Persistent Epithelial Defects

SIGNIFICANCE This case series demonstrates successful use of PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) for overnight wear among patients with persistent epithelial defects, while exploring the efficacy of using PROSE reservoir for autologous hematopoietic products during treatment. PURPOSE This case series proposes a strategic approach to the treatment of refractory cases of persistent epithelial defect via overnight PROSE device wear. CASE REPORTS We followed three patients with persistent epithelial defect treated with PROSE devices and observed expedited defect resolution and improvement in best-corrected visual acuity over the course of 2 to 4 weeks. In addition to moxifloxacin and preservative-free saline, autologous hematopoietic products were added to the reservoir of two patient's PROSE devices. Patients were advised to wear their PROSE device at all times except for lens cleaning and replacement of reservoir contents every 12 hours. CONCLUSIONS Together, these cases demonstrated the safety and efficacy of overnight wear of PROSE devices in the treatment of refractory persistent epithelial defect (PED).