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Corey Miller, Annahita Amireskandari, Thomas Mauger, Chantelle Mundy, Cynthia J Roberts, Mark A Slabaugh, Andrew Hendershot; Do scleral lenses reduce the need for corneal transplant in some patients?. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3082.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate and describe the characteristics of patients utilizing scleral lenses as an alternative to corneal transplant for various corneal pathologies.
Retrospective chart review of patients who were prescribed scleral lenses or underwent corneal transplant between 2010 and 2015 at a single center. Inclusion criteria included adult patients age 18-100 with corneal pathology (dystrophies, ectasia, scars) who received corneal topography. Patients that did not return for follow-up were excluded.
A total of 61 eyes of 41 patients were evaluated. Patients who were successfully fitted for scleral lenses were defined as those who successfully avoided undergoing corneal transplant. Twenty-two eyes of 12 patients were successfully fitted for scleral lenses. 8 were female and the mean age was 56.6 years +/- 16.8. Thirty-nine eyes of 29 patients required corneal transplantation. Eleven were female and the mean age was 63.2 years +/- 10.3. Of the patients who were successfully fitted for scleral lenses, 4 had prior penetrating keratoplasty (PK), 12 had keratoconus, 2 had post-LASIK ectasia, 2 had pellucid marginal degeneration, and 2 had scarring from previous radial keratotomy (RK). Of the patient’s who required corneal transplant, the primary diagnoses were as follows: 13 keratoconus, 12 corneal scarring from trauma or infection, 7 lattice dystrophy, 4 granular dystrophy, 3 Fuch’s dystrophy. The following transplant types were performed in these patients: 29 PK, 3 deep anterior lamellar keratoplasty, 1 Descemet’s stripping endothelial keratoplasty, and 1 keratoprosthesis.
Scleral lenses may be beneficial for patients with certain corneal pathologies including failed PK, keratoconus, post-LASIK ectasia, RK scarring, and pellucid marginal degeneration. The use of scleral lenses may allow some patients to avoid initial or repeat PK but may be limited in patients with scarring from trauma or infections, some patients with keratoconus, and in those with lattice, granular or Fuch’s dystrophies. Further investigation into the efficacy of scleral lenses for different corneal pathologies is warranted.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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