Patient Acceptance and Tolerance of Semi-Scleral Contact Lenses

Yan, Peng

Patient Acceptance and Tolerance of Semi-Scleral Contact Lenses

Saturday, April 26, 2014: 3:06 PM

Room 155 (Boston Convention and Exhibition Center)

Peng Yan, MD, University of Ottawa Eye Institute, Ottawa, Ontario, Canada

Mustafa Kapasi, MD, University of Ottawa Eye Institute, Ottawa, ON, Canada

Salina Teja, MD, University of Ottawa Eye Institute, Ottawa, ON, Canada

Ronan J. Conlon, MD, University of Ottawa, Ottawa, ON, Canada

Joshua C. Teichman, MD, MPH, University of Ottawa Eye Institute, Oakville, ON, Canada

Kashif Baig, MD, MBA, Ottawa Eye Institute, Ottawa, ON, Canada

Narrative Responses:

Purpose
To evaluate short-term visual outcome, patient acceptance and tolerance of semi-scleral contact lenses (SSCL) in the management of various corneal pathologies.

Methods
Single-center retrospective observational chart review, of 28 patients (34 eyes) with various corneal pathologies who were offered Maxim 5R SSCLs for non-surgical optimization of visual correction. Patients were followed at one and three months for assessment of best-corrected visual acuity with SSCL, comfort, length of daily wear, and complications. Those who were intolerant were offered lubrication and/or custom fitting options.

Results
Eighteen patients (22 eyes), of the 28 patients offered, opted to purchase SSCLs. Fourteen patients had previously undergone ocular surgery, including penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), and intraocular lens implantation. The mean best-corrected visual acuity was 20/100 prior to SSCL and 20/40 with SSCLs (p = 0.038). A mean improvement in visual acuity of 4 ± 2 lines was documented. At one-month follow-up, average length of wear was 7.9 ± 1.5 hours/day. Eighteen eyes were comfortable with sSCLs and 4 eyes were intolerant due to corneal irritation secondary to inadequate sagittal height in sSCLs.

Conclusion
SSCLs may be a comfortable management option for patients with keratoconus and other corneal pathologies unable to achieve adequate visual outcome with traditional spectacles or corneal rigid gas permeable contact lenses. They offer significant improvement in visual outcome and may delay or eliminate the need for further surgical interventions.