Preliminary Clinical Exploration of Scleral Lens Performance on Normal Eyes
Main Article Content
Abstract
Abstract
Objectives: The purpose of this study was to evaluate the performance (i.e. vision, comfort and fit) of spherical and front-surface toric scleral lenses in subjects with regular, healthy corneas.
Methods: Scleral lenses were fit in the eyes (n = 16) of healthy subjects (n = 9) with regular corneas, absent of pathology, and studied using an observational, multi-visit design. Lens fit was objectively evaluated by an experienced practitioner. Following 1 month of successful lens wear, participants completed subjective satisfaction surveys regarding the scleral lens-wearing experience.
Results: According to participant surveys, scleral lenses were subjectively preferred over soft toric or gas permeable contact lenses in 88% of eyes, including in all eyes fit with a front-surface toric scleral lens (n = 3). Seventy-five percent (75%) of eyes achieved visual acuity of 0.1 logMAR or better, while all eyes with prior spectacle wear achieved visual acuity with a scleral lens within 1 Snellen line of spectacle correction. Seventy-five percent (75%) of eyes achieved good subjective comfort with a scleral lens. No participants reported poor subjective vision and/or comfort.
Conclusions: Our findings suggest that subjects preferred the performance of a scleral lens (spherical or front-surface toric) compared to a soft toric or gas permeable contact lens. Moreover, scleral lenses may provide a viable, alternative contact lens modality option for patients considering discontinuation of traditional soft toric and/or rigid contact lens wear; so long as the factors associated with hypoxia remain minimized.
Key Words: scleral lens; scleral contact lens; front-surface toric scleral lens; lens performance; normal eyes; healthy eyes
Downloads
Article Details
Copyright of articles published in all DPG titles is retained by the author(s). The author(s) grants DPG the rights to publish the article and identify itself as the original publisher. The author grants DPG exclusive commercial rights to the article. The author grants any party the rights to use the article freely for non-commercial purposes provided that the original work is properly cited.
References
Bowen TJ. Contact Lenses: The Story. Kent: Bower House Publications; 2009.
Fick AE. A contact lens. 1888. Arch Ophthalmol 1997;115:120–1.
Barnett M, Johns LK. History of Scleral Lenses. In: Contemporary Scleral Lenses: Theory and Application. Bentham Science; 2017. ISBN: 978-1-68108-567-8.
Ezekiel D. Gas permeable haptic lenses. J Br Contact Lens Assoc 1983:158–61.
Rosenthal P, Cotter J. The Boston Scleral Lens in the management of severe ocular surface disease. Ophthal-mol Clin North Am 2003;16:89–93.
Pullum KW, Buckley RJ. A study of 530 patients referred for rigid gas permeable scleral contact lens assessment. Cornea 1997;16:612–22.
Schornack MM. Scleral lenses: a literature review. Eye Contact Lens 2015;41:3–11.
van der Worp E, Bornman D, Ferreira DL, et al. Modern scleral contact lenses: A review. Cont Lens Anterior Eye 2014;37:240–50.
Barnett M, Johns LK. Scleral Lenses for the Regular / Normal / Non-Diseased Cornea. In: Contemporary Scleral Lenses: Theory and Application. Bentham Science;2017:133–4.
Nichols JJ, Willcox MD, Bron AJ, et al. The TFOS International Workshop on Contact Lens Discom-fort: executive summary. Invest Ophthalmol Vis Sci 2013;54:TFOS7-TFOS13.
Schlanger JL. A study of contact lens failures. J Am Optom Assoc 1993;64:220–4.
Weed K, Potvin R. Discontinuation of contact lens wear. Optom Vis Sci 1993;70:140.
Pritchard N, Fonn, D, Brazeau D. Discontinuation of contact lens wear: a survey. Intern Contact Lens Clinic 1999;26:157–61.
Young G, Veys, J., Pritchard, N., Coleman, S. A multi-centre study of lapsed contact lens wearers. Ophthal Physiol Opt 2002;22:516–27.
Richdale K, Sinnott LT, Skadahl E, Nichols JJ. Frequency of and factors associated with contact lens dissatisfaction and discontinuation. Cornea 2007;26:168–74.
Dumbleton K, Woods CA, Jones LW, Fonn D. The impact of contemporary contact lenses on contact lens discontinuation. Eye Contact Lens 2013;39:93–9.
Holden BA. The principles and practice of correcting astimgatism with soft contact lenses. Aust J Optom 1975;58:279–99.
Michaud L, Barriault C, Dionne A, Karwatsky P. Empirical fitting of soft or rigid gas-permeable contact lenses for the correction of moderate to severe refractive astigma-tism: a comparative study. Optometry 2009;80:375–83.
Lafosse E, Romin DM, Esteve-Taboada JJ, et al. Compari-son of the influence of corneo-scleral and scleral lenses on ocular surface and tear film metrics in a presbyopic population. Cont Lens Anterior Eye 2018;41:122–7.
Maeda N. Evaluation of optical quality of corneas using corneal topographers. Cornea 2002;21:S75–8.
Roberts B, Athappilly G, Tinio B, et al. Higher order aberrations induced by soft contact lenses in normal eyes with myopia. Eye Contact Lens 2006;32:138–42.
Sabesan R, Johns L, Tomashevskaya O, et al. Wavefront-guided scleral lens prosthetic device for keratoconus. Optom Vis Sci 2013;90:314–23.
Craig JP, Nelson JD, Azar DT, et al. TFOS DEWS II Report Executive Summary. Ocul Surf 2017;15:802–12. 24. Alipour F, Kheirkhah A, Jabarvand Behrouz M. Use of mini scleral contact lenses in moderate to severe dry
eye. Cont Lens Anterior Eye 2012;35:272–6.
Jaynes J, Weissman BA, Edrington T. Predicting scleral
GP lens entrapped tear layer oxygen tensions. Cont Lens Anterior Eye 2015;38:392.
Compan V, Oliveira C, Aguilella-Arzo M, et al. Oxygen diffusion and edema with modern scleral rigid gas permeable contact lenses. Invest Ophthalmol Vis Sci 2014;55:6421–9.
Compan V, Aguilella-Arzo M, Edrington TB, Weiss-man BA. Modeling corneal oxygen with scleral gas permeable lens wear. Optom Vis Sci 2016;93:1339–48.
Paugh JR, Chen E, Heinrich C, et al. Silicone hydrogel and rigid gas-permeable scleral lens tear exchange. Eye Contact Lens 2018;44:97–101.
Michaud L, van der Worp E, Brazeau D, et al. Predicting estimates of oxygen transmissibility for scleral lenses. Cont Lens Anterior Eye 2012;35:266–71.
Bergmanson JP, Ezekiel DF, van der Worp E. Scleral contact lenses and hypoxia: Theory versus practice. Cont Lens Anterior Eye 2015;38:145–7.
Vincent SJ, Alonso-Caneiro D, Collins MJ, et al. Hypoxic corneal changes following eight hours of scleral contact lens wear. Optom Vis Sci 2016;93:293–9.
Giasson CJ, Morency J, Melillo M, Michaud L. Oxygen tension beneath scleral lenses of different clearances. Optom Vis Sci 2017;94:466–75.
Fadel D. Modern scleral lenses: Mini versus large. Cont Lens Anterior Eye 2017;40:200–7.
Turpin S, Caroline P, Kojima R, et al. Does IOP Increase During Scleral Lens Wear? In: Global Specialty Lens Symposium (GSLS). Las Vegas, NV; 2018.
Nau CB, Schornack MM, McLaren JW, Sit AJ. Intraocu-lar pressure after 2 hours of small-diameter scleral lens wear. Eye Contact Lens 2016;42:350–3.
Vincent SJ, Alonso-Caneiro D, Collins MJ. Evidence on scleral contact lenses and intraocular pressure. Clin Exp Optom 2017;100:87–8.
Alonso-Caneiro D, Vincent SJ, Collins MJ. Morphological changes in the conjunctiva, episclera and sclera following short-term miniscleral contact lens wear in rigid lens neophytes. Cont Lens Anterior Eye 2016;39:53–61.