Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE)

Prosthetic replacement of the ocular surface ecosystem (PROSE) is a pioneering treatment that can restore vision, support healing, reduce irritating symptoms and improve quality of life for patients with complex corneal disease, especially those for whom conventional treatments have failed. The UCSF PROSE Clinic is one of only two PROSE providers in the western United States and there are fewer than 20 such centers worldwide. Only major medical centers with expertise in treating complex corneal disease may fit patients with PROSE devices, which are manufactured by the Boston Foundation for Sight.

PROSE can benefit patients with conditions that include dry eye syndrome, keratoconus, Stevens-Johnson syndrome, chronic ocular graft-versus-host disease, Sjögren's disease, pellucid marginal degeneration, ocular trauma, and complications of either LASIK or cornea transplantation. The treatment offers continued benefit: Almost 75 percent of recipients with complex corneal disease have improved vision and continue to wear the devices five years after initiating the therapy.

PROSE devices are transparent nickel-size domes made of gas-permeable plastic, allowing oxygen to reach the eye's surface. They fit under the eyelids and rest on the sclera (the relatively insensitive white tissue), establishing a vault over the damaged cornea and protecting the surface from the environment and blink trauma. The devices are filled with sterile saline at the time of insertion, creating a reservoir of fluid that continuously bathes the ocular surface in oxygen-providing artificial tears. PROSE doctors design and fit devices to each patient's unique eye shape and to meet specific treatment goals.