The Boston Scleral Lens in the treatment of pediatric patients.
OBJECTIVE
To report the use of a custom-designed, fluid-ventilated, gas-permeable scleral lens in the treatment of patients under 13 years of age.


METHODS
We retrospectively reviewed the medical records of all patients under 13 years of age who were fitted with the Boston Scleral Lens at the Boston Foundation for Sight from January 1996 through June 2006. Age, sex, ophthalmic diagnosis, systemic diagnosis, prior surgical intervention, complications, lens fit and wearing failures, and duration of lens use are reported.


RESULTS
Boston Scleral Lenses were fitted in 47 eyes of 31 patients referred after failure of conventional therapy. Patients ranged in age from 7 months to 12.92 years (mean, 7.75 years) at time of fitting. There were 16 girls and 15 boys in this group. The mean duration of documented scleral lens use was 24 months (range, 0-85 months). A broad range of refractive and ocular surface disorders was treated with this modality, with the vast majority of patients having ocular surface disease (27/31, 87%) rather than refractive disorders (4/31, 13%). Congenital corneal anesthesia syndromes and Stevens-Johnson syndrome each accounted for over one-third of the patients.


CONCLUSIONS
The Boston Scleral Lens is a custom-designed, fluid-ventilated, rigid gas-permeable scleral lens that vaults the cornea retaining a pool of oxygenated artificial tears over the corneal surface. The Boston Scleral Lens is a treatment option, after failure of conventional therapy, for a broad range of ocular surface and refractive disorders in the pediatric age group. Pediatric ophthalmologists should be aware of this treatment modality, particularly in the management of severe ocular surface disease.
Gungor
Inci
I
Boston Foundation for Sight, Needham, Massachusetts 02494, USA.
Schor
Kenneth
K
Rosenthal
Perry
P
Jacobs
Deborah S
DS
D002648:Child; D002675:Child, Preschool; D003262:Contact Lenses, Extended-Wear; D003316:Corneal Diseases / Q000503:physiopathology / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012590:Sclera; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity