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Serge Doan, Maud Elluard, Eric E. Gabison, Isabelle Cochereau, Agnes Delcampe; Efficacy Of Gas Permeable Scleral Lenses In Refractory Severe Dry Eye Syndrome. Invest. Ophthalmol. Vis. Sci. 2012;53(14):572.
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Gas-permeable large diameter modern scleral lenses have shown their efficacy in severe ocular surface diseases such as Stevens-Johnson syndrome. Their geometry allows hydration and protection of the cornea and of the limbus. This study determined the efficacy of modern scleral contact lenses in severe eye dry syndrome.
A retrospective single-center study was conducted in patients with severe refractory dry eye syndrome, who were fitted with SPOT®scleral lenses (LAO, Thonon, France). At inclusion and after 3 months of daily wear, the following parameters were assessed: Ocular Surface Disease Index (OSDI) score, NEI Visual Function Questionnaire-25 composite score (NEI VFQ-25), best-corrected visual acuity, slit lamp examination, number of associated drugs and tolerability.
The files of 10 patients (9 women and 1 man) with a mean age of 58.4 years (40-80 years), were reviewed. Dry eye was related to Sjögren syndrome (6 patients), ocular cicatricial pemphigoid (3 patients) and graft versus host disease (1 patient). Lens fitting failed in 1 case. Improvement of quality of life scores (OSDI and NEI NFQ-25) was remarkable in seven patients out of the nine fitted patients. Mean OSDI and NEI VFQ-25 scores improved from 73.5±16.8 to 35±24.2 (p=0.002) and from 49.0±21.0 to 70.5±18.4 (p=0.045), respectively. Best corrected visual acuity improved by 3.2±4.3 Snellen lines. Mean follow-up was 12.6±3.8 months. No serious adverse events attributable to the scleral lenses occurred.
Scleral lenses are a promising therapeutic in patients with severe refractory dry eye syndrome. The results can be spectacular with a dramatic improvement of patients’ quality of life. Difficulties in manipulation represent the main disadvantage.
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