Boston ocular surface prosthesis: an Indian experience.

Area of Science:

• Ophthalmology
• Corneal Disease
• Ocular Surface Disease

Background:

• Boston ocular surface prosthesis (BOSP) is a scleral contact lens.
• Used for rigid gas permeable (RGP) lens failures in corneal ectasias (e.g., keratoconus).
• Also indicated for ocular surface diseases like Stevens-Johnson syndrome (SJS).

Purpose of the Study:

• To report the utilization and outcomes of BOSP in a tertiary Indian eye care center.
• Evaluate BOSP effectiveness in managing complex corneal and ocular surface conditions.

Main Methods:

• Retrospective chart review of 32 patients (43 eyes) fitted with BOSP (July 2008-May 2009).
• Assessed indications for BOSP fitting, visual acuity (VA) changes, and symptom relief (pain, photophobia).
• Statistical analysis using paired t-test (SPSS v16.0).

Main Results:

• BOSP was fitted for RGP failures (23 eyes) and SJS (20 eyes).
• In RGP failures, mean LogMAR VA improved from 1.13 to 0.29 (P < 0.001).
• In SJS patients, mean LogMAR VA improved from 0.84 to 0.56 (P < 0.001), with 35% experiencing >2 lines VA improvement and symptom relief.

Conclusions:

• BOSP effectively improves visual acuity in patients with irregular astigmatism, ectasias, and RGP failures.
• BOSP also enhances vision and alleviates symptoms in patients suffering from Stevens-Johnson syndrome.