Scleral contact lenses may help where other modalities fail.
OBJECTIVE
To describe the vision-correcting and therapeutic benefits of gas-permeable scleral contact lenses (GP-ScCL) in the management of irregular corneal surface disorders and ocular surface diseases.


METHODS
The charts of 48 consecutive patients (66 eyes) whose management included the use of GP-ScCL were reviewed.


RESULTS
The most common indication for fitting the lenses was keratoconus in patients who had to stop wearing other types of corneal lenses (44 eyes, 74.6%). Other indications included extreme corneal irregularity after penetrating keratoplasty, nonhealing corneal ulcer, postoperative dry eye syndrome following laser in situ keratomileusis (LASIK), severe exposure keratitis and acid burn. Mean follow-up was 17 months (range, 2-96). Mean wearing time of the GP-ScCL was 16.2 hours per day (range, 3-18). Visual acuity of 20/40 or better was achieved in 90.9% of keratoconus patients and in 81.8% of postkeratoplasty patients. A gain of two or more Snellen lines was observed in 94.5% of eyes treated for improving vision. Marked subjective improvement in quality of life was reported by 86% of the patients, mainly as a result of improvement in their visual function and reduction in discomfort. Five patients (seven eyes) failed to wear GP-ScCL.


CONCLUSIONS
GP-ScCL can provide successful and safe visual and therapeutic solutions for ocular conditions when conventional contact lenses and medical treatment have failed and where surgery is undesirable or contraindicated.
Segal
Ori
O
Department of Opthalmology, Assaf Harofeh Medical Center, Zerifin, Israel. orisegal@netvision.net.il
Barkana
Yaniv
Y
Hourovitz
Dafna
D
Behrman
Shmuel
S
Kamun
Yifaa
Y
Avni
Isaac
I
Zadok
David
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003261:Contact Lenses; D003316:Corneal Diseases / Q000209:etiology / Q000628:therapy; D004867:Equipment Design; D005128:Eye Diseases / Q000628:therapy*; D005260:Female; D005740:Gases; D006801:Humans; D007640:Keratoconus / Q000628:therapy; D015948:Keratoplasty, Penetrating / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010539:Permeability; D019233:Retreatment; D012590:Sclera; D016896:Treatment Outcome
D005740:Gases