title: Change in vault during scleral lens trials assessed with anterior segment optical coherence tomography.
abstract: OBJECTIVE
  To assess the change in vault during scleral lens fitting with anterior segment optical coherence tomography (AS-OCT).
  
  
  METHODS
  This study comprised of patients who had AS-OCT performed after 1h and 4h of scleral lens wear (PROSE, prosthetic replacement of the ocular surface ecosystem, Boston Foundation for Sight, Needham Heights, MA, USA). Vault was measured on AS-OCT as the distance between the front surface of the cornea in the center and the back surface of the scleral lens.
  
  
  RESULTS
  Fifty eyes of 41 patients were analyzed. The main indications for scleral lens trial were ectasia (keratoconus, post surgery) (n=20 eyes) and ocular surface disease (OSD - Stevens - Johnson syndrome, dry eyes and limbal stem cell deficiency) (n=30 eyes). Mean age of the patients was 31.4 years. Twenty were males. The diameter of the scleral lens ranged from 16mm to 18.5mm. Vault measurements reduced in 45/50 eyes (90%), remained same (n=2) or increased (n=3). Overall mean vault decreased from 680±421μm at 1h to 589±355μm (p=<0.001) at 4h of lens wear. Mean vault in ectasia was 759±574μm and 634±455μm (p=0.02) at 1h and 4h of lens wear respectively. In OSD group, mean vault was 626±276μm and 558±273μm (p<0.01) at 1h and 4h of lens wear respectively. Average reduction in the vault was 125μm in ectasia and 68μm in OSD group.
  
  
  CONCLUSIONS
  Vault reduced significantly after 4h of lens wear during scleral lens trial indicating that the final assessment of the scleral lens may be done after 4h of lens wear.
authors.affiliation: Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India. Electronic address: varsharathi@lvpei.org.
authors.forename: Varsha M
authors.initials: VM
authors.lastname: Rathi
authors.affiliation: Bausch & Lomb Contact Lens Centre, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, TS, India.
authors.forename: Preeji S
authors.initials: PS
authors.lastname: Mandathara
authors.affiliation: Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India; Bausch & Lomb Contact Lens Centre, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, TS, India.
authors.forename: Srikanth
authors.initials: S
authors.lastname: Dumpati
authors.affiliation: Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India.
authors.forename: Virender S
authors.initials: VS
authors.lastname: Sangwan
mesh_terms: D000328:Adult; D000869:Anterior Eye Segment / Q000473:pathology*; D003261:Contact Lenses; D003315:Cornea / Q000473:pathology; D004867:Equipment Design; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D012590:Sclera; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity
keywords: ASOCT; Optical coherence tomography; PROSE; Scleral contact lens; Vault