Corneal Response to Scleral Contact Lens Wear in Keratoconus

Cagliari, Cristina; Schor, Paulo; Formentin, Luiz; Lipener, César; Santos, Myrna Serapião dos; Oliveira, Helena Coutinho Franco de; Raulino, José Ney de Carvalho; Freitas, Denise de

doi:10.1097/icl.0000000000000899

Cited by 4 publications

(4 citation statements)

References 40 publications

(67 reference statements)

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“…Iqbal et al 23 showed that a scleral lens with a central lens thickness of 200 to 400 mm did not induce corneal edema after 6 hr of contact lens wear in patients with keratoconus. Cagliari et al 24 followed up with 22 patients with keratoconus who were fitted with scleral lenses for 90 days. They showed that there was no significant change in endothelial morphology and pachymetry values over time.…”

Section: Discussionmentioning

confidence: 99%

Mini-Scleral Lens: An Effective Mode of Visual Rehabilitation in Eyes With Resolved Hydrops

Sinha,

Anjum,

Dwivedi

et al. 2024

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objectives: To evaluate the visual outcome of mini-scleral contact lenses (MSLs) in keratoconus following the resolution of acute hydrops. Methods: This was a prospective observational case series of patients of healed hydrops in keratoconus fitted with an MSL (Keracare, Acculens, Lakewood, CO) who were managed for acute hydrops medically or surgically at least 3 months prior. Uncorrected visual acuity, best spectacles-corrected visual acuity, best lens-corrected visual acuity, topographic indices, keratometric indices, contact lens parameters, and ocular aberrometric changes were evaluated. All patients were followed up for at least 3 months. Results: Eighteen eyes of 17 patients were included in the analysis. The mean post-hydrops topographic values of the eyes included flat keratometric value (K1) 64.93±10.88 (range 44.30–93.40) diopters (D), steep keratometric value (K2) 70.41±10.92 D (range 45.8–98.6 D), and Kmax of 79.53±17.73 D (range 50–130.2). The final mini-scleral lens's mean dioptric power was −8.56±3.96 D (range −18 to −4). Visual acuity significantly improved from post-hydrops resolution uncorrected visual acuity of 1.5±0.71 logMAR to 0.79±0.18 logMAR best spectacles-corrected visual acuity to 0.27±0.01 logMAR best lens-corrected visual acuity (P-value <0.0001). Similarly, there was considerable improvement in corneal aberrometric values after wearing an MSL. At the 3-month follow-up, 15 patients (16 eyes) were compliant to contact lens use with a minimum of 6 to 8 hr daily while two patients (2 eyes) were poorly compliant. Conclusions: A MSL is a valuable option for visual rehabilitation in keratoconus following the resolution of acute hydrops.

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Section: Discussionmentioning

confidence: 99%

Mini-Scleral Lens: An Effective Mode of Visual Rehabilitation in Eyes With Resolved Hydrops

Sinha,

Anjum,

Dwivedi

et al. 2024

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…16 In fact, they were considered the gold standard for patients with advanced KC, 16–18 but numerous studies reported the benefits of SL versus RGPCL for advanced corneal irregularities, achieving greater comfort, centration, stability, and providing good VA and long-term safety and efficacy. 19–25 The latter is discussed by Fuller et al showing an excellent long-term safety and efficacy of SL in the visual rehabilitation in subjects with KC, therefore achieving an improvement in VA. 21 Cagliari et al 22 also evaluated safety and highlighted that the daily use of SL in KC patients was not associated with adverse effects on the cornea or endothelium over a 90-day period and they did not find a progression of the disease. Vincent et al 25 stated that SL may provide exceptional VA outcomes in patients with complex corneal shapes that otherwise would not be achieved with a smaller diameter rigid lens.…”

Section: Discussionmentioning

confidence: 99%

“…28,33 Although for KC, in the initial stages, the best options are HCL and STCL, 16,30,32,34 it has been reported that in more advanced stages of the disease, the best VA is only achieved with RGPCL or SL. [16][17][18][19][20][21][22][23][24]27,28 SL allow correcting the ametropia and HOA that these patients usually present, 27 and although some authors wage for corneo-scleral modality, 20,27 others defend full scleral modality, 16,26 and have also reported successful improvements with MSCL. 10,14…”

Section: Keratoconusmentioning

confidence: 99%

Evidence of Contact Lenses for Vision Rehabilitation in Corneal Diseases: A Review

Vilà Porsell,

Rodriguez Lopez,

Rocha-de-Lossada

et al. 2023

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…[ 28 ] In a study done by Cagliari et al ., variables related to endothelial morphology and pachymetry values did not change significantly over time from the above study. [ 29 ]…”

Section: Discussionmentioning

confidence: 99%

Quality of life and vision assessment with scleral lenses in keratoconus

Hadimani,

Kaur,

Shinde

et al. 2023

Saudi Journal of Ophthalmology

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PURPOSE: The purpose of the study is to evaluate the visual outcomes and improvement in quality of life (QOL) of patients with keratoconus with scleral lenses. METHODS: In this prospective study, 14 patients (28 eyes) with bilateral keratoconus were fitted with scleral lenses (McAsfeer 16.00 mm) in Pune city, Maharashtra, India. Uncorrected visual acuity (VA), best spectacle-corrected VA, and VA with scleral lenses were evaluated. The patients were given the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) for judging the QOL, before and after using scleral lenses for 3 months. RESULTS: The mean uncorrected VA of the 14 patients with a mean age of 28.64 ± 6.57 years was 1.18 ± 0.19 logMAR. Best spectacle-corrected high-contrast VA improved from 0.47 ± 0.25 logMAR to 0.03 ± 0.07 logMAR with scleral lenses (P < 0.001). Best spectacle-corrected low-contrast VA improved from 0.68 ± 0.22 logMAR to 00.47 ± 0.10 logMAR with scleral lenses (P < 0.001). Along with the increase in overall median scores on the NEI VFQ-25 from 1735 to 2930 points (P < 0.001), the distance and near activities (P < 0.001), vision-specific mental health (P < 0.002), social functioning (P < 0.004), and driving (P < 0.005) improved after using scleral lenses for 3 months. CONCLUSION: Scleral lenses can be an effective and safe management option for patients with keratoconus leading to an improved vision and QOL.

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Corneal Response to Scleral Contact Lens Wear in Keratoconus

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 4 publications

References 40 publications

Mini-Scleral Lens: An Effective Mode of Visual Rehabilitation in Eyes With Resolved Hydrops

Mini-Scleral Lens: An Effective Mode of Visual Rehabilitation in Eyes With Resolved Hydrops

Evidence of Contact Lenses for Vision Rehabilitation in Corneal Diseases: A Review

Quality of life and vision assessment with scleral lenses in keratoconus

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