Are PROSE lenses superior to other scleral lenses? Why?

[CC00]

When deciding which scleral lenses to choose, I was going to go with PROSE but the cost is substantially higher. But if PROSE is much better, then it's worth it. But I'm not clear why they may be better. Can anyone inform me?

[CC00]

Anyone know?

[alb1967]

Here is what BFS for sight says about their lens: PROSE (prosthetic replacement of the ocular surface ecosystem) treatment devices were developed by the Boston Foundation for Sight. The devices are made of gas-permeable plastic and rest on the sclera of the eye. This design allows for a reservoir of fluid which can continuously bathe the ocular surface, providing constant lubrication. Other benefits can include improved vision (by ******g surface corneal irregularities) and damage prevention due to the outer layer of protection over the cornea and conjunctiva. If you are interested, you can use this link to read more about the specific mechanisms utilized in PROSE treatment.

In order to understand how PROSE devices would compare to other scleral lenses, there are three factors that are important to consider: (1) a patient’s goals, needs, and capabilities, (2) a patient’s underlying medical condition, and (3) the success of the fit of the device. Therefore, it’s difficult to provide a specific answer about how PROSE treatment compares with lenses fit by other providers, because of the numerous factors at play. You can read here to learn more about PROSE treatment for individuals with dry eye.

Wishing you well in determining the best treatment for your dry eye, and don’t hesitate to contact me if I can answer any further questions for you.

Warmly,

Janice M. Epstein
Online Community Advocate
Boston Foundation for Sight
connectedvisions@bostonsight.org


I personally have the newest Jupiter lenses and they have worked well for me for 8 months so far. There are good and bad days just like any other chronic disease but so far I really like
them and I only paid $1200.00 for noth. Andrea

[heyjude0701]

I have been wearing PROSE lenses for a couple of years. I was very happy with them but they no longer fit. My right eye developed a nodule on the sclera (unrelated to the lens) and now my left eye is showing some abrasion from the lens rubbing, so I need to be fitted for new lenses in each eye. My health insurance company paid for much of the cost of the PROSE lenses but now I am on Medicare, which does not cover scleral lenses for dry eye syndrome. Also, I moved cross country and no longer have a PROSE clinic near me. I am going to try Jupiter lenses. I will post here after I am fitted and wearing them for a while how they compare with the PROSE.

[Leuk]

I've just started the fitting process for PROSE lenses. Regarding the $$., my full charge is $10000.00, which is probably more than what a non-PROSE center opthalmologist would charge for commercial scleral lenses. But I assume that in that case you would be paying under a vision plan, rather than a medical plan. I, on the other hand have an underlying medical condition, so the charge is partially covered under my medical plan. (It will be at most $1500 out of pocket since I've exhausted my deductible already, and am obligated for 15% thereafter until maximum out of pocket - which I am rapidly approaching.)
Regarding the technology, it seems to me the optical challenge for any scleral lens mfr. is to make the first refractive surface quality even better than what it is for a healthy human cornea. This is because the healthy cornea has frequent tearing/blinking action to compensate (make smooth) by continual slight wetting of that surface. But, as a scleral contact wearer, if you have dry eye and want peak vision, you are still going to have to apply artificial tears every once in a while to wet over any residual surface roughness on the outer contact surface, I can't say how this quality on a PROSE contact compares to the other commercial lenses, although I know an engineer personally who worked with the Prose people (BostonSight) on this property. I also know from personal experience however that, as the artificial tears dry off, my vision - with the fitting contacts - became noticeably cloudier, The vision I have with a dry Prose contact is still much much better than what I have with my punctally eroded cornea wet (just usable vision for ~ 30 seconds after applying tears) or dry (can't drive, read, or use a computer).
So, my bottom line, in part because of my insurance situation, is to go with PROSE, although the optho I have been using works out of a PROSE center, so there's a little inertia involved as well.
Finally, if you go with PROSE, make sure you don't straddle a lens on the edge of the carrying case before closing it, Each lens has a replacement cost of $750 .

[heyjude0701]

I am on my second round of fittings with the Jupiter lenses, and so far, I think the PROSE were much better. The PROSE were larger (mine were 19mm) and the reservoir held the saline solution all day. The Jupiters are much smaller (between 15mm and 16 mm). They feel like there is a foreign object in my eyes, and my eyes feel much dryer with the Jupiters than they did with the PROSE (thought I used artificial tears roughly every hour or two with both kinds of scleral lenses). The Jupiters are making my eyes red also. It is possible that a larger diameter Jupiter lens will be more comfortable; I will ask the eye doctor about that. I'm not sure what to do if I can't get a good fit with the Jupiters. If I were guaranteed that the PROSE would work again, I would spend the money, but whatever it was that made my PROSE lenses uncomfortable (and made my eyes red) after about two years might happen again.