Visual and physiological outcomes of scleral lens wear

Schornack, Muriel; Nau, Cherie B; Nau, Amy; Harthan, Jennifer; Fogt, Jennifer Swingle; Shorter, Ellen

doi:10.1016/j.clae.2018.07.007

Cited by 28 publications

(25 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study observed relatively low rates of asymptomatic or symptomatic corneal infiltrative events, contact lens–associated red eye, and pingueculitis evenly distributed for 1.3% of eyes each. Both Schornack et al 10 and Visser et al 26 found a lower rate of infiltrates in 0.6 (n = 164) and 0.0% (n = 284), respectively. The inconsistency may represent a difference in the study design, which included a variety of indications for scleral lens wear and differing length of study periods.…”

Section: Discussionmentioning

confidence: 86%

“…Although keratoconic patients typically account for most subjects, most of the studies did not evaluate subjects with keratoconus in isolation. 2 , 3 , 7 – 10 , 32 , 61 In our study, only subjects with keratoconus and no prior corneal surgery and at least 1 year of wearing experience were included to assess the long-term scleral lens safety without regard to the increased risks associated with post-surgical eyes. The study design also separated long-term adverse events from those encountered in the initial fitting period, which warrants separate study.…”

Section: Discussionmentioning

confidence: 99%

“…Our subjects, in general, experienced lower rates of major complications compared with other scleral lens safety studies that included post-operative eyes. 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.…”

Section: Discussionmentioning

confidence: 99%

“… 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%

“… 30 All of these studies included a variety of corneal pathologies and scleral lens indications. 2 , 7 , 8 , 10 , 23 , 31 , 32…”

mentioning

confidence: 99%

See 4 more Smart Citations

Safety and Efficacy of Scleral Lenses for Keratoconus

Fuller

Wang

2020

Optom Vis Sci

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 86%