title: Scleral lens tolerance after corneal cross-linking for keratoconus.
abstract: OBJECTIVE
  Subjective and objective evaluation of scleral lens tolerance and fitting before and after corneal cross-linking (CXL) for progressive keratoconus.
  
  
  METHODS
  In this prospective cohort, evaluations were made of 18 unilateral eyes in patients who underwent CXL and had been wearing scleral lenses before the procedure. All the patients gave informed consent; they were able to cooperate with the study, were eligible for CXL, had been wearing well-fitting scleral lenses for at least 3 months, and had no other active ocular disease. Data were collected before and 1 year after CXL. Outcome measures were changes in clinical and subjective scleral lens performance. The following components were studied: scleral lens corrected distance visual acuity, scleral lens specifications, scleral lens fit, wearing time, and subjective measures on visual analogue scale questionnaires (1 to 100 mm).
  
  
  RESULTS
  There was no significant change in scleral lens corrected distance visual acuity (p = 0.632). Sixty-one percent of eyes needed a scleral lens fit and/or power change. Wearing time (median, 16 hours per day) and subjective tolerance were found to be stable.
  
  
  CONCLUSIONS
  Scleral lens tolerance after CXL appeared to be stable.
authors.affiliation: *MSc †BOptom ‡MD, PhD Visser Contact Lens Practice, Nijmegen, The Netherlands and Visser Contact Lens Practice, and Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands (E-SV); Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands (NS); and Zonnestraal Eye Hospital Amersfoort, Amersfoort, The Netherlands (NGT).
authors.forename: Esther-Simone
authors.initials: ES
authors.lastname: Visser
authors.forename: Nienke
authors.initials: N
authors.lastname: Soeters
authors.forename: Nayyirih G
authors.initials: NG
authors.lastname: Tahzib
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D015331:Cohort Studies; D003094:Collagen / Q000378:metabolism; D003261:Contact Lenses; D003319:Corneal Stroma / Q000378:metabolism; D003432:Cross-Linking Reagents; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011446:Prospective Studies; D017755:Prosthesis Fitting; D012590:Sclera; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen