How Does The Use Of Scleral Contact Lenses Affect Intraocular Pressure, Corneal Parameters, And Choroidal Structure?

This prospective study was to evaluate the effect of scleral contact lens (SCL) wear on intraocular pressure (IOP) and central corneal thickness (CCT) and compare the choroidal parameters of patients using scleral contact lens (SCL)  and healthy control groups.

Department of Ophthalmology, Marmara University School of Medicine, İstanbul, Turkey.

Thirteen eyes of 13 keratoconus patients wearing SCL and 13 eyes of healthy age matched participants were included in this prospective study. IOP was measured using i-Care before and after 4 hours of SCL wear following lens removal. The lens fit and CCT were evaluated by anterior segment OCT (AS-OCT) after 1 hour of SCL wear. Retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) were evaluated in all patients by Spectral domain optical coherence tomography before and after 4 hours of SCL wear. The subfoveal choroidal thickness (SFCT) was measured with Enhanced depth imaging mode OCT. The choroidal vascularity index (CVI), the proportion of the luminal area to the total choroidal area, was assessed with ImageJ software.

The mean age of patients was 30.8 ± 11.8 years. The mean follow-up was 3.9 ± 3.8 years (range; 1-13 years). No significant difference was observed between the mean IOP before SCL wear (11.53 ± 3.17 mmHg) and 4 hours of SCL wear (11.47 ± 5.16 mmHg) (p=0.969). CCT obtained by AS-OCT was 431.5 ± 71.5 μm. The mean CCT was 355 ±130.2 μm. While mean RNFL thickness values remained stable (p=0.368), the average macular ganglion cell complex was significantly thinner at the end of the 4 hours (p=0.014). The mean SFCT and CVI values remained stable during follow-up (p>0.05). Compared to the healthy control, there was no statistical difference in CVI measurements in patients using SCL after 4 hours of SCL wear (p=0.762).

IOP measured following lens removal did not vary significantly during the four hours of lens wear in scleral lens. In addition, long-term use of scleral lenses did not have an effect on CVI.