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Do scleral lenses reduce the need for corneal transplants in severe keratoconus?

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Session Details

Session Title: Medical Cornea & Biomechanics

Session Date/Time: Sunday 23/09/2018 | 08:00-10:00

Paper Time: 09:09

Venue: Room A3, Podium 3

First Author: : E.Kreps BELGIUM

Co Author(s): :    L. Vermeulen   C. Koppen                 

Abstract Details


To investigate the success and failure rates of scleral lens correction in severe keratoconus


Antwerp University Hospital, Belgium


Retrospective case series of keratoconus patients who attended the keratoconus clinic between 2010 and 2014. We included 75 eyes with maximal keratometry values above 70 diopters, as measured using the sagittal curvature map that was obtained by Scheimpflug tomography. Exclusion criteria included amblyopia, mental retardation and concomitant ocular disease that limited their visual potential. Scleral lens fitting was proposed for the 75 eyes included in the study.


Scleral lenses were prescribed in 51 eyes and 3 eyes were successfully fitted with corneal or hybrid lenses. Transplant surgery was performed in 8 eyes due to insufficient visual acuity with the lenses, intolerance and/or handling issues. Twelve eyes did not require lens fitting because of good vision in the other eye or a contraindication for lens wear. The mean gain in visual acuity (lens vs spectacle-corrected visual acuity) was 0.54 ± 0.18 (decimal fraction, Snellen eye chart). Forty eyes wore the lenses at last follow-up visit. Four eyes abandoned scleral lens wear due to handling difficulties.


Forty of the 51 eyes with severe keratoconus that would otherwise have undergone transplant surgery were successfully treated with long-term scleral lens wear. In this way, the indication for keratoplasty was more than halved in our keratoconus population.

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