Analysis of Prosthetic Replacement of the Ocular Surface Ecosystem Anterior Surface Condition Using Noninvasive Keratograph Break-Up Time

Objectives:Noninvasive keratograph break-up time (NIKBUT) was developed as an alternative to fluorescein-based measurements of tear break-up time and may have utility not only for the objective evaluation of tear film stability on the corneal surface but also on the surface of scleral and contacts lenses. We report on two cases that highlight the potential use of NIKBUT to provide objective prelens tear film stability data to evaluate the anterior surface of a customized ocular surface prosthetic devices (PD; PROSE, BostonSight, Needham, MA).Methods:Case report and literature review.Results:Case 1 demonstrates improvement in prelens tear film stability with NIKBUT increasing from 4.59 to 11.47 sec after the addition of a polyethylene glycol-based polymer coating to the PD surface. In case 2, when a NIKBUT value could not be obtained, keratograph infrared images were used to evaluate improved anterior lens surface wetting.Conclusion:Noninvasive keratograph break-up time may provide an objective modality to evaluate prelens tear film stability and PD wettability. Such measurements may allow for a better understanding of visual degradation related to PD lens condition and the appropriate timing of lens recoating, reconditioning, and replacement.