Key Takeaways

  • PROSE treatment was associated with statistically significant improvements in both Mackie stage and visual acuity among 87 patients with neurotrophic keratitis
  • Patients reached their lowest Mackie stage in an average of 31.18 days following treatment, indicating relatively prompt corneal healing
  • The retrospective findings support considering PROSE as a therapeutic option for neurotrophic keratitis across a range of disease severities while highlighting the need for further prospective research

BostonSight reported new data supporting the use of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment for patients with neurotrophic keratitis (NK), according to findings presented at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting. The poster, "Mackie Stage Improvement in Neurotrophic Keratopathy with Use of PROSE," was authored by Ken Whang, Estelle Crowley, and Daniel Brocks, MD.

PROSE devices have been used to manage a range of ocular surface diseases, but their effectiveness across the spectrum of neurotrophic keratitis severity has not been well characterized, according to BostonSight. The retrospective observational study evaluated PROSE as a therapeutic intervention for patients with NK, a vision-threatening degenerative corneal disease caused by impaired corneal nerve function. Disease severity was assessed using the three-stage Mackie Classification system.

Investigators reviewed clinical data from November 2008 through September 2023, analyzing outcomes from 87 eyes of 87 patients diagnosed with NK. The cohort included 8 eyes with Stage 0 disease, 57 with Stage 1, 17 with Stage 2, and 5 with Stage 3 disease. Paired t-tests and Wilcoxon rank tests were used to compare outcomes before and after PROSE treatment, with statistical significance defined as a p-value below 0.05.

According to the findings, patients experienced statistically significant improvements in both mean Mackie stage and mean visual acuity following PROSE treatment. The average time to reach the lowest Mackie stage was 31.18 days, suggesting relatively rapid corneal healing in the study population.

"The study concludes that PROSE treatment is an effective tool and should be considered when treating neurotrophic keratitis," said Daniel Brocks, MD, chief medical officer at BostonSight. "Neurotrophic keratitis is a stubborn disease, which has high risk of causing vision loss. These results illustrate the effectiveness of PROSE to save vision and induce prompt corneal tissue healing."

The investigators noted that the findings expand the evidence supporting PROSE treatment in patients with neurotrophic keratitis across multiple stages of disease severity. While the retrospective design limits conclusions regarding causality, the observed improvements in both disease stage and visual outcomes suggest the therapy may provide meaningful clinical benefit for patients with this challenging ocular surface disorder.