Jupiter Scleral Lenses

Pecego, Mariana Gomes; Barnett, Melissa; Mannis, Mark J.; Durbin‐Johnson, Blythe

doi:10.1097/icl.0b013e31824daa5e

Cited by 72 publications

(25 citation statements)

References 11 publications

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“…Another scleral lens challenge is a phenomenon known as "midday fogging" (MDF). This accumulation of debris in the post-lens tear reservoir (TR) causes a significant reduction in visual performance in many individuals, necessitating removal of the scleral lens and re-application after instillation of fresh solution [7,8]. MDF affects 20-33% of scleral lens wearers, and in one study cohort, limited consecutive scleral lens wear time to an average of just 4.45 h per day before lens removal and re-application was needed [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

A measure of tear inflow in habitual scleral lens wearers with and without midday fogging

Skidmore

Walker

Marsack

et al. 2019

Contact Lens and Anterior Eye

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The purpose of this pilot study was to evaluate tear inflow in a scleral lens system using fluorophotometry, and indirectly assess the exchange of the tear reservoir in habitual scleral lens wearers with the presence or absence of midday fogging (MDF). Methods: Habitual scleral lens wearers (n=23) and normal scleral lens neophytes (n=10) were recruited. Of the 23 habitual wearers, 11 of them experienced MDF and 12 did not have a diagnosis of MDF. Contact lens-fitting characteristics were evaluated using ocular coherence tomograpy (OCT) and biomicroscopy. High molecular weight fluorescein (FITC) Dextran was instilled into the tear reservoir beneath the scleral lens, and the tear fluid fluorescein concentration was measured using the Fluorotron fluorophotometer. Calculated fluorescein concentrations were plotted over time to measure the fluorescein decay rate of the tear fluid beneath the scleral lens, which was used to calculate the tear exchange rate. Results: There was no significant difference in tear inflow between the MDF group (mean: 0.111%) and the non-MDF group (mean: 0.417%), and there was a high amount of variability seen in the rates (p = 0.26). In addition, there was no significance between the tear reservoir thickness in the MDF (283um) and non-MDF (326um) groups (p = 0.53). Conclusions: The relationship between the amount of tear exchange during scleral lens wear and the incidence of MDF was not significant. Additional studies are needed to further examine the role of tear exchange in MDF and address the causes of variability to improve measurement techniques with fluorophotometry in the scleral lens system.

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Section: Introductionmentioning

confidence: 99%

A measure of tear inflow in habitual scleral lens wearers with and without midday fogging

Skidmore

Walker

Marsack

et al. 2019

Contact Lens and Anterior Eye

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“… 1 It was estimated that in 2016, 70,000 individuals in the United States wore a scleral lens. 2 Modern scleral lens indications include corneal ectasia (27.5 to 91%), 3 – 10 post-surgical or post-traumatic corneal irregularity (17.6 to 40.0%), 3 – 6 , 8 – 10 ocular surface diseases (3 to 49%), 3 – 5 , 7 – 11 aphakia (2 to 23%), 3 , 7 – 9 refractive errors (2.6 to 10%), 3 , 8 , 10 , 11 and others. 1 , 12 Keratoconus is the primary indication for scleral lens wear.…”

mentioning

confidence: 99%

“…Although lamellar or full-thickness keratoplasty improves visual acuity in eyes with corneal scarring, it must be noted that scleral lenses may still be necessary to reach the best-corrected post-surgical visual acuity. 7 – 9 , 22 …”

mentioning

confidence: 99%

“…3 Other more contemporary studies have focused on case reports and case series or are limited by small sample sizes in a single lens type. 7 , 23 – 25 Common physiological complications include hypoxia leading to corneal edema (7.4%), 3 neovascularization (1.1 to 13.3%), 3 , 26 corneal abrasion (3.1%), 3 and infection, inflammation, and solution toxicity. 2 , 3 , 7 , 23 – 25 , 27 – 29 Other lens-related adverse events are midday fogging (20 to 46%; McKinney et al IOVS 2013;54:ARVO E-Abstract 5483), 2 , 11 mechanical irritation (12.6%), 3 protein deposits (3.5%), 3 giant papillary conjunctivitis (1.7%), 3 and poor lens fit due to disease progression.…”

mentioning

confidence: 99%

“… 7 , 23 – 25 Common physiological complications include hypoxia leading to corneal edema (7.4%), 3 neovascularization (1.1 to 13.3%), 3 , 26 corneal abrasion (3.1%), 3 and infection, inflammation, and solution toxicity. 2 , 3 , 7 , 23 – 25 , 27 – 29 Other lens-related adverse events are midday fogging (20 to 46%; McKinney et al IOVS 2013;54:ARVO E-Abstract 5483), 2 , 11 mechanical irritation (12.6%), 3 protein deposits (3.5%), 3 giant papillary conjunctivitis (1.7%), 3 and poor lens fit due to disease progression. 2 , 3 , 7 , 23 – 25 , 27 – 29 A survey of 164 scleral lens practitioners revealed that common minor complications include poor lens wetting (90.8%), lens fogging (84.8%), blurred vision (53%), ocular redness (34.8%), ocular dryness (24.4%), and ocular pain/discomfort (20.7%).…”

mentioning

confidence: 99%

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Safety and Efficacy of Scleral Lenses for Keratoconus

Fuller

Wang

2020

Optom Vis Sci

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SIGNIFICANCE This study affirms the long-term safety and efficacy of scleral contact lens use in patients with keratoconus. PURPOSE This study aimed to evaluate the safety and efficacy of contemporary scleral contact lenses in the visual rehabilitation of the keratoconic population. METHODS A retrospective study of keratoconic subjects examined between 2013 and 2018 was conducted. Subjects were included regardless of age, sex, pre-existing morbidity, or scleral lens design. Only eyes fit successfully with scleral contact lenses for ≥1 year were included. Exclusion criteria were prior corneal surgery, dystrophy, degeneration, and trauma. RESULTS A total of 157 eyes of 86 subjects met the study criteria. The mean Keratoconus Severity Score at initial fitting was 3.6 ± 1.0. Lenses were gas-permeable and nonfenestrated, with a mean overall diameter of 15.8 ± 0.6 mm and 70.1% toric scleral periphery. Physiological adverse events occurred in 9.6% of eyes, including microbial keratitis (0.6%), phlyctenulosis (0.6%), corneal abrasion (1.3%), contact lens–induced acute red eye (1.3%), corneal infiltrative events (1.3%), pingueculitis (1.3%), and hydrops (3.2%). Lens-related adverse events were documented in 55.4% of eyes. Adverse events related to surface issues included poor wetting in 1.9%, handling in 3.8%, reservoir fogging in 7.0%, lens intolerance in 7.6%, deposit in 8.9%, and broken lenses in 26.1% of eyes. The most common management strategies involved refits (54.0% of interventions), patient reeducation (29.5%), medical treatment (5.5%), surgical referral (6.8%), adjustment to wear time (2.5%), surface treatment (1.2%), and lens replacement (0.6%). Best-corrected distance logMAR visual acuity improved significantly from a mean of 0.50 in spectacles to a mean of 0.08 in scleral lenses ( P < .0001). During the study period, 14.6% of eyes lost best-corrected scleral lens visual acuity, all from keratoconus progression. CONCLUSIONS Consistent with other groups, our study demonstrates excellent safety and efficacy of scleral contact lenses in subjects with keratoconus.

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