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Humberto Salazar, Paul Chamberlain, Sumitra Khandelwal; Outcomes of scleral contact lens use in veterans. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3084.
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© ARVO (1962-2015); The Authors (2016-present)
Scleral contact lenses (ScCL) are utilized in a variety of ocular conditions. Their uses and the factors associated with outcomes in veterans have not been studied. The purpose of this study is to determine what factors correlate with discontinuation of ScCL use in veterans.
This retrospective analysis reviewed patients who were fitted with ScCl from January 2010 to December 2015 at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC). Patients that discontinued ScCL use at any point after fitting were assigned to group A, while patients that continued their use were assigned to group B. Patients’ demographic factors, including age, gender, and race, indication for ScCL fitting, previous RGP contact lens (RGPCL) use, the presence of comorbid ocular, psychiatric, and neurologic diseases, visual acuity before and after scleral lens fitting, and daily lens wear time were compared between the groups. Descriptive statistics and logistic regression analyses were used for statistical analysis.
Sixty-five eyes of 36 patients were fitted with ScCL in the study period. Mean age of patients was 65.5 years (SD=14.2) and the most common indication for ScCL fitting was corneal ectasia. Twenty-three eyes (33%) discontinued the use of the lenses. The indications for ScCL fitting were similar between both groups. Patient age predicted ScCL discontinuation, with each additional year increasing the likelihood of discontinuation (p=0.044, OR 1.07, 95% CI 1.01-1.14). Black race, compared to white race, was associated with a decreased likelihood of discontinuation (p<0.01, OR 0.07, 95% CI 0.01-0.45). Improvement in visual acuity measured by logMAR was also associated with a decreased likelihood of discontinuation (p=0.037). Gender (p=0.078), the presence of another ocular disease (p=0.211) and a history of previous RGPCL use (p=0.895) were not associated with discontinuation.
Advancing age is associated with discontinuation of ScCL use, likely due to difficulty with insertion and removal. Conversely, black race and improvement in vision measured by LogMAR were associated with a decreased likelihood of discontinuation. The analysis will be augmented upon further chart review. This study will aid in determining which patients are good candidates for ScCL fitting and improving outcomes.
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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