Scleral Lens Applications Focused on Korean Patients with Various Corneal Disorders

Korean J Ophthalmol. 2023 Apr;37(2):157-165. doi: 10.3341/kjo.2022.0164. Epub 2023 Mar 23.

Abstract

Purpose: We aimed to report on the clinical outcomes of scleral lens applications in Korean patients with various corneal disorders.

Methods: This retrospective review was conducted for 62 eyes of 47 patients who had been fitted with scleral lenses for various corneal disorders. The patients were referred for inadequate spectacle-corrected visual acuity and rigid gas permeable (RGP) or soft contact lens intolerance. Uncorrected visual acuity, habitually corrected visual acuity, best lens-corrected visual acuity, topographic indices, keratometry indices, and lens parameters were evaluated.

Results: Twenty-six eyes of 19 patients with keratoconus were enrolled. Other conditions included corneal scar (13 eyes of 12 patients), phlyctenules (three eyes), laceration (four eyes), chemical burn (one eye), keratitis (one eye), Peters' anomaly (one eye), fibrous dysplasia (one eye), ocular graft-versus-host disease (two eyes of one patient), irregular astigmatism (18 eyes of 12 patients), and corneal transplant status (five eyes of four patients). The mean topographic values of the eyes include flat keratometric value (43.0 ± 6.1 diopters [D]), steep keratometric value (48.0 ± 7.4 D), and astigmatism (4.9 ± 3.6 D). Of the eyes fitted with scleral lenses, best lens-corrected visual acuity (0.10 ± 0.22 logarithm of the minimum angle of resolution [logMAR]) was significantly better than the habitually corrected visual acuity (0.59 ± 0.62 logMAR, p < 0.001).

Conclusions: Scleral contact lenses are a good alternative for patients with corneal abnormalities and those who are intolerable to RGP contact lenses, resulting in both successful visual outcomes and patient satisfaction, especially concerning keratoconus, corneal scar, and corneal transplant status.

Keywords: Corneal diseases; Keratoconus; Scleral contact lens.

MeSH terms

  • Astigmatism*
  • Contact Lenses
  • Corneal Diseases* / epidemiology
  • Corneal Diseases* / surgery
  • Corneal Injuries* / epidemiology
  • Corneal Injuries* / surgery
  • Humans
  • Keratoconus* / epidemiology
  • Keratoconus* / surgery
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Sclera*

Supplementary concepts

  • Peters anomaly