Scleral Lenses

Schornack, Muriel

doi:10.1097/icl.0000000000000083

Cited by 86 publications

(43 citation statements)

References 139 publications

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“… 22 The overall success rate of scleral family lenses has been reported 70–80% in the literature review variable in different indications. 8 Their highly gas permeable material makes them a good option for correcting aphakia since they are required to be used for longer hours in this situation. As the MSD lenses are smaller and less expensive than scleral lenses, and they might be easier to fit, they can be better choices when compared to other lenses of the scleral family in patients with ocular surface abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

Alipur

Hosseini

2016

Journal of Current Ophthalmology

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PurposeTo evaluate visual results, comfort of use, safety, and efficacy of mini scleral contact lenses in optical management in patients with traumatic aphakia and severe concomitant irido-corneal injury.MethodsIn a case series, eight eyes with post traumatic aphakia and severe concomitant irido-corneal injury that were evaluated at the Contact Lens Clinic of Farabi Eye Hospital, Tehran, Iran for contact lens fitting and could not be corrected with conventional corneal RGP contact lenses were fitted with miniscleral contact lenses. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), and BCVA (Best corrected visual acuity) with miniscleral lens were recorded. Slit lamp examination, comfortable daily wearing time, and any contact lens-related complication were documented in each follow-up visit.ResultsThe mean UCVA and BSCVA of the cases was >2.7 and 0.41 LogMAR, respectively (BSCVA could not be assessed in one case due to severe corneal irregularity). The mean final BCVA with the miniscleral lens was 0.05 LogMAR (range from 0.4 to −0.04 LogMAR). The mean follow-up period was 14.6 months. The mean comfortable daily wearing time (CDWT) was 11.6 h, ranging from 8 to 16 h. The only contact lens-related complication was mild redness and irritation that was observed in 2 patients during the follow-up visits. All patients were comfortable with handling these lenses.ConclusionMiniscleral contact lenses can be considered a safe and effective option in aphakia patients with concurrent corneal scarring secondary to ocular injury for whom surgical intervention would be complicated.

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Section: Discussionmentioning

confidence: 99%

Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

Alipur

Hosseini

2016

Journal of Current Ophthalmology

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“… 2 , 10 In a literature review of scleral lenses, Schornack et al 70 reported two incidence rates, between 0.5 and 1.6%, 28 of microbial or Acanthamoeba keratitis among post-surgical eyes or those with severe ocular surface disease, which are known risk factors for infection. 71 Zimmerman and Marks 54 reported on a case of microbial keratitis associated with poor compliance with scleral lens use in a case of neurotrophic keratitis. Walker et al 2 reviewed 11 cases of microbial keratitis from the literature, all of which either were post-surgical eyes or had pre-existing epithelial defects.…”

Section: Discussionmentioning

confidence: 99%

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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“…They have recently gained more interest among practitioners around the world and are one of the first and best visual correction options for eyes that are unsuccessful with conventional contact lens modalities. Evolutions in lens materials, production techniques and improved knowledge on anterior ocular surface anatomy, boosted the indications of scleral lens fitting, varying from severely irregular corneas to normal/ healthy corneas [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Determination of central corneal clearance in scleral lenses with an optical biometer and agreement with subjective evaluation

Macedo-de-Araújo

Amorim‐de‐Sousa

Queirós

et al. 2019

Contact Lens and Anterior Eye

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To compare three methods to measure central corneal clearance (CCC) during scleral lens wear: subjective (slit lamp), image processed (ImageJ) and with an optic biometer. The optic biometer technique was validated in comparison to an OCT in the first part of the study. Methods: Twenty-two eyes (11 subjects) with healthy corneas were recruited. Three measures of OCT with scleral lens and ten measurements of axial length (AL) with IOLMaster with and without lens were performed. For the second part, 61 eyes (35 subjects) enrolled in a clinical study were selected. Measurements of CCC were done with IOLMaster, SlitLamp and ImageJ. Results: The measurements of CCC indirectly obtained with IOLMaster had a strong correlation with AS-OCT measurements (r = 0.981), showing a mean difference of 122.18 ± 46.05 μm (higher with IOLMaster). Regarding the second part, measurements of CCC were 238.66 ± 95.94 μm, 250.16 ± 124.31 μm and 263.15 ± 90.60 μm, for the IOLMaster, SlitLamp and ImageJ, respectively. The correlations were higher for ImageJ vs Subjective measure (r = 0.891) than for IOL vs Subjective (r = 0.748) and IOL vs ImageJ (r = 0.745). Analysis of differences and correlations between SlitLamp and ImageJ through time showed a mean difference of-32.28 ± 89.95 μm (r = 0.683) at V1month, 12.53 ± 59.46 μm (r = 0.850) at V6months and 11.57 ± 32.95 μm (r = 0.940) at V12months. Conclusions: It is possible to measure CCC with IOLMaster, considering AL measured with and without lens and lens thickness. The three methods tested have good correspondence, showing that IOLMaster and ImageJ could be objective techniques to measure CCC. Also, it is possible to improve the agreement of subjective measures when compared to objective measures trough time.

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Scleral Lenses

Cited by 86 publications

References 139 publications

Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

Safety and Efficacy of Scleral Lenses for Keratoconus

Determination of central corneal clearance in scleral lenses with an optical biometer and agreement with subjective evaluation

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