Characterization And Prediction Of The Clinical Result With A Specific Model Of Mini-Scleral Contact Lens In Corneas With Keratoconus

To investigate which factors are correlated with the visual improvement achieved with a specific model of scleral contact lens (ScCL) in keratoconus (KC) eyes and to define a model to predict such improvement according to the pre-fitting data.

Group of Optics and Visual Perception. Department of Optics, Pharmacology, and Anatomy, University of Alicante, Spain

Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain

Longitudinal retrospective study including 30 eyes of 18 patients (age, 14-65 years) with KC fitted with the ScCL ICD16.50 (Paragon Vision Sciences). Visual, refractive, corneal tomographic and ocular aberrometric changes were evaluated during a 3-month follow-up. Likewise, the characterization of the post-lens meniscus was performed by optical coherence tomography (OCT) with the measurement of central, nasal and temporal vaults.

The visual acuity (VA) increased significantly from a mean pre-fitting value with spectacles of 0.23±0.07 logMAR to a mean value of 0.10±0.04 after 1 month of ScCL wear (p<0.001). An improvement of 1 or more lines of VA with the ScCL occurred in 62.1% of the eyes. A significant decrease in central, nasal, and temporal vault was observed after 1 month of ScCL wear (p≤0.046). Furthermore, a significant reduction of ocular high order (p=0.028) and primary coma root mean square (p=0.018) was found with the ScCL. A predicting linear equation of the change in VA achievable with the ScCL was obtained (p<0.001, R²=0.878) considering the pre-fitting spectacle corrected distance visual acuity, and the power and sagittal lens of SCL.

The scleral contact lens evaluated provides an efficacious visual rehabilitation in KC due to the improvement of VA and the correction of the low and high order ocular aberrations. This VA improvement can be predicted from some pre-fitting variables.