title: Clinical outcomes of scleral Misa lenses for visual rehabilitation in patients with pellucid marginal degeneration.
abstract: OBJECTIVE
  To report the clinical outcomes of scleral Misa®lenses (Microlens Contactlens Technolgy, Arnhem, Netherlands) for visual rehabilitation in patients with pellucid marginal degeneration (PMD).
  
  
  METHODS
  In this prospective interventional case series, 24 eyes of 12 PMD patients were fitted with scleral Misa®lenses. Patients were followed regularly for continuous daily wearing time (CDWT), contact lens handling issues, visual acuity, and any subjective or objective contact lens related complications.
  
  
  RESULTS
  The mean patient age was 35.0±13.8 years (range, 23-47 years). The average length of follow-up was 14.1±3.7 months (range, 8.5-18 months). All eyes were fit with mini Misa®scleral lenses with a diameter of 16.5 or 17mm. The mean Snellen best-corrected visual acuity (BCVA) before scleral lenses with spectacle correction was 0.42±0.15 (range, 0.2-0.6). With scleral lenses, mean BCVA was 0.75±0.15 (range, 0.5-0.9), (p=0.003) with a mean gain of 3.3 lines of BCVA. More than half (16 eyes, 67%) reported wearing their scleral lenses for 8h or more on a daily basis. Three patients (6 eyes, 25%) abandoned scleral lens wear. Patients who abandoned the scleral lens wear tended to have a better spectacle corrected visual acuity and less gain of lines.
  
  
  CONCLUSIONS
  Scleral lenses can be used succesfully in patients with PMD who are intolerant to other types of contact lenses. Patients who have a low spectacle BCVA and a higher gain of visual acuity with scleral lenses are good candidates for scleral lens use.
authors.affiliation: Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey. Electronic address: leylaerk@yahoo.com.
authors.forename: Leyla
authors.initials: L
authors.lastname: Asena
authors.affiliation: Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
authors.forename: Dilek Dursun
authors.initials: DD
authors.lastname: Altınörs
mesh_terms: D000328:Adult; D003261:Contact Lenses; D003316:Corneal Diseases / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017755:Prosthesis Fitting / Q000379:methods; D012590:Sclera; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation*; D014792:Visual Acuity; D055815:Young Adult
keywords: Corneal ectasia; Pellucid marginal degeneration; Scleral contact lenses; Visual rehabilitation