PROSE scleral lens: a novel aid for staged eyelid reconstruction

Ophthalmic Plast Reconstr Surg. 2014 Sep-Oct;30(5):e119-21. doi: 10.1097/IOP.0b013e3182a64fc9.

Abstract

A 50-year-old man presented with a papillomatous tarsoconjunctival tumor involving the medial two-thirds of the left upper eyelid. Office biopsy revealed papillary squamous cell carcinoma (SCCA). Rapid tumor growth with caruncular and forniceal conjunctival involvement continued, despite a trial of weekly interferon-α2b intralesional injection therapy. Surgical excision with clear margins resulted in a large upper eyelid defect. The suspicion for recurrence remained, given the aggressive nature of the tumor. A temporary prosthetic replacement of the ocular surface ecosystem (PROSE) scleral lens was fit for preservation of the ocular surface and visual function during a 1-month observation period. No evidence of recurrence was noted, and the eyelid defect was successfully reconstructed with a Cutler-Beard procedure. Local disease was controlled; unfortunately, metastatic disease was found in the ipsilateral parotid gland 1 year later. Aggressive surgical removal is recommended in interferon-α2b nonresponsive SCCA tumors. The PROSE scleral contact lens may serve as a useful adjunct for the maintenance of a healthy ocular surface and visual function during delayed eyelid defect repair.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Conjunctival Neoplasms / pathology
  • Conjunctival Neoplasms / surgery*
  • Contact Lenses*
  • Ecosystem
  • Eyelid Neoplasms / pathology
  • Eyelid Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures*
  • Plastic Surgery Procedures*
  • Sclera*