Using Scleral Lenses in Asian Eyes

Friday, April 17, 2015
KIOSKS (San Diego Convention Center)
Vanissa Wing See Chow, FRCOphthHK, FRCSEd

Purpose
To evaluate the process and outcome of fitting scleral lenses in Asian Eyes for visual rehabilitation in corneal and ocular surface diseases after failing other forms of contact lens or conservative treatment.

Methods
Retrospective review of the first 15 patients who were referred for fitting of scleral lenses was conducted. 15.8mm Mini-Scleral Design lenses were used. Patients who continued wearing the scleral lenses had at least 1 year of follow-up.

Results
Eighteen eyes of 15 patients were analysed. 16 eyes (89%) were successfully fitted, while 9 eyes (56%) of 6 pateints continued using the lenses at their latest follow-up.  Average of 1.7±0.5 lenses (range, 1 to 2) were required for a successful fit.  Average parameters of the lenses fitted were: sagittal depth 4.8±0.3mm (range, 4.4 to 5mm), mid-peripheral 0.9±0.9 increase (range, standard to double increase), and scleral edge 1.8±0.7 flat (range, 1 to 3 flat). Mean logMAR visual acuity improved by 0.56±0.38 (range, -1.48 to 0, p=0.001). Average patient satisfaction score was 3.8 out of 5.

Conclusion
The one-year outcome was satisfactory. The fitting principle and trial lenses of MSD lenses were effective in allowing novice practitioners to fit scleral lenses in Asian eyes with their unique geometry, tighter eyelids and smaller palpebral fissures. Asian eyes often needed a flatter scleral edge than what trial lenses offered.