Original Research Article
Year: 2018 | Month: Februaryy | Volume: 8 | Issue: 2 | Pages: 60-66
Clinical Applications and Therapeutic Outcomes of Scleral Contact Lenses- A Retrospective Study
Archana Preethi C1, Pallavi Joshi2, Umesh Y3
1Fellow, 2Consultant, 3Chief Medical Officer & Senior Consultant,
Department of Cornea and Refractive Surgery, Sankara Eye Hospital, Bangalore.
Corresponding Author: Archana Preethi C
ABSTRACT
Objective: To evaluate the indications and efficacy of semi and mini scleral contact lenses.
Materials and Methods: A total database of 45 eyes of 38 consecutive patients fitted with semi scleral or mini scleral lenses between January 2015 and December 2016, was retrospectively analyzed. All lenses were fitted by a preformed protocol. Ocular indications included keratoconus, pellucid marginal degeneration (PMD), post radial keratotomy (RK), Stevens-Johnson syndrome (SJS), post traumatic corneal scars, chronic blepharokeratoconjunctivitis and high refractive errors. National Eye Institute Visual Function Questionnaire (VFQ-25) was used to measure quality of life among patients wearing scleral lenses (n= 16).
Results: 79% of the patients were male. Maximum (34.2%) cases were seen in the age group 21 to 30 years. The mean follow up was 12 months (range 4-18 months). Major indications for the use of scleral contact lens was keratoconus (53.3%) followed by post radial keratotomy (17.8%), SJS (15.6%), post traumatic corneal scar (6.7%), PMD (2.2%), pathological myopia with aphakia (2.2%) and chronic blepharokeratoconjunctivitis (2.2%). Overall, mean visual acuity before using scleral lenses was LogMAR 0.59±0.32,which improved to 0.24±0.19 after using scleral lenses, which was statistically significant(p<0.001).Among individual etiologies, significant improvements in visual acuity was seen in patients with keratoconus, post radial keratotomy and SJS. Quality of life as assessed by Visual Function Questionnaire (VFQ-25) showed significant improvement in all the vision specific parameters like social functioning, mental health, role difficulties and dependency (p<0.001).
Conclusion: Scleral contact lenses are effective in the management of various degrees of irregular corneas of different etiologies which couldn’t be managed with conventional lenses. These lenses have become a useful tool in ocular surface abnormalities as a protective interface in addition to providing significant improvement in visual acuity and quality of life. Thus scleral contact lenses have emerged as an effective option as well as a bridge to prevent or postpone surgeries and their associated irreversible complications.
Key words: scleral lenses; therapeutic lenses; visual acuity; irregular cornea; quality of life