Scleral Lens Applications Focused on Korean Patients with Various Corneal Disorders

Abstract

Purpose: We aimed to report on the clinical outcomes of scleral lens applications in Korean patients with various corneal disorders.Methods: This retrospective review was conducted for 62 eyes of 47 patients who had been fitted with scleral lenses for various corneal disorders. The patients were referred for inadequate spectacle-corrected visual acuity and rigid gas permeable (RGP) or soft contact lens intolerance. Uncorrected visual acuity, habitually corrected visual acuity, best lens-corrected visual acuity, topographic indices, keratometry indices, and lens parameters were evaluated.Results: Twenty-six eyes of 19 patients with keratoconus were enrolled. Other conditions included corneal scar (13 eyes of 12 patients), phlyctenules (three eyes), laceration (four eyes), chemical burn (one eye), keratitis (one eye), Peters’ anomaly (one eye), fibrous dysplasia (one eye), ocular graft-versus-host disease (two eyes of one patient), irregular astigmatism (18 eyes of 12 patients), and corneal transplant status (five eyes of four patients). The mean topographic values of the eyes include flat keratometric value (43.0 ± 6.1 diopters [D]), steep keratometric value (48.0 ± 7.4 D), and astigmatism (4.9 ± 3.6 D). Of the eyes fitted with scleral lenses, best lens-corrected visual acuity (0.10 ± 0.22 logarithm of the minimum angle of resolution [logMAR]) was significantly better than the habitually corrected visual acuity (0.59 ± 0.62 logMAR, <i>p</i> < 0.001).Conclusions: Scleral contact lenses are a good alternative for patients with corneal abnormalities and those who are intolerable to RGP contact lenses, resulting in both successful visual outcomes and patient satisfaction, especially concerning keratoconus, corneal scar, and corneal transplant status.

Visual rehabilitation with scleral contact lenses in patients with irregular astigmatism

“…In the present study, the cases associated with it were a total of 5. Most cases were derived from keratoconus (13,14), which is consistent with the findings of other studies.…”

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

“…Lee et al evaluated the use of SCL in various corneal disorders, and they also showed statistically significant improvement in BLCVA with contact lenses from UCVA (1.2660.7-0.2160.36 logMAR in corneal scars and 1.3660.85-0.1260.20 logMAR in keratoconus). 3 Along with the improvement in visual acuity, an appreciable improvement in corneal aberrations was also noted in our study. The results were consistent with those shown by Sidi Mohamed Hamida et al 19 and Montalt et al 20 Kumar et al studied the effect of MSL on visual acuity and ocular higher-order aberrations in 15 eyes with keratoconus and concluded that MSL significantly reduced ocular aberrations and improved visual acuity in patients with keratoconus.…”

“…Yan et al 9 reported that 91% of patients had comfortable 10-hr daytime lens wear. However, Lee et al 3 in their study found that four eyes of three patients out of 18 eyes of 12 patients using scleral contact lenses for corneal scarring stopped using contact lenses due to insufficient visual quality improvement as they already had good vision with habitual corrected visual acuity.…”

“…1,2 However, the small diameter of the lens makes it difficult for patients with severe or advanced corneal lesions to center the corneal RGP lens, which results in poor fitting and unsatisfactory improvement in visual acuity. 3 Scleral contact lenses (SCLs) are a good option in these patients when other lens options have failed and can be used to prevent or delay surgery. 4 A lens that rests entirely on the sclera is classified as a scleral lens (up to 25 mm in diameter maximum).…”