Intraocular Pressure After 2 Hours of Small-Diameter Scleral Lens Wear

Abstract

Objectives Compression of episcleral veins or deformation of tissue in the Schlemm canal beneath the landing zone of scleral lenses could elevate intraocular pressure (IOP). We examined the effect of 2 hours of small-diameter scleral lens wear on IOP. Methods Twenty-nine participants, 29 ± 6 years old (mean ± SD) who had no history of eye disease or scleral lens wear were included in the study. Each participant was fitted with a 15-mm Jupiter scleral lens on 1 eye (study eye). IOP was measured in both eyes by pneumatonometry centrally on the cornea and peripherally on the sclera. The lens was then placed on 1 eye and was worn for 2 hours. IOP was remeasured immediately after lens placement, at 1 and 2 hours of lens wear, and immediately after lens removal. IOP after removal of the scleral lens was compared to IOP before placing the lens and to IOP in the control eye by using paired t-tests. Results Immediately after removing the scleral lens, mean central IOP in the study eye (13.9 ± 3.1 mm Hg) was not different from mean central IOP in the control eye (13.5 ± 2.2 mm Hg, P=.4) or in the same eye before lens wear (13.6 ± 1.9 mm Hg, P=.6). There were also no differences in IOP measured peripherally at 2 hours of lens wear (P=.8). Conclusions Neophyte scleral lens wear of a 15-mm scleral lens for 2 hours does not increase IOP in healthy eyes.

Visual and physiological outcomes of scleral lens wear

“…Speculation that scleral lens wear may cause an increase in intraocular pressure is a matter of some concern within the eye care community [22,. In this population, only one patient was reported to experience a significant increase in intraocular pressure in one eye.…”

Response to Re: A hypothesis that scleral contact lenses could elevate intraocular pressure

“…Any rise in IOP may also depend on aqueous drainage facility, which might be restricted in some individuals. In addition and as suggested by Nau and colleagues, aqueous drainage may be compromised by lenses with bearing areas at the limbus.…”

“…For example, the well conducted study by Nau and colleagues found no significant difference between the mean IOP recorded before and during scleral lens wear; however, some subjects were found to have increased pressure. Such findings might be a consequence of increased susceptibility to scleral lens‐induced IOP elevation due to having thinner scleral tissue.…”

Optical coherence tomography and scleral contact lenses: clinical and research applications

“…Tissue compression will vary with each lens design (primarily influenced by the tangent and curvature of the landing zone, the total lens diameter, and potentially the insertion technique). Tissue compression may affect tear exchange, comfort during lens wear, the extent of conjunctival staining following lens removal, and potentially intraocular pressure given the location of the haptic zone to the canal of Schlemm (Figure ) …”