Patient age is not a significant barrier to adoption of customized scleral devices.

Abstract

Purpose: To compare ease of adoption of a customized scleral device in patients of different ages.

Methods: Twenty-five patients (47 eyes) referred to the Weill Cornell Department of Ophthalmology for PROSE device fitting between July 1st, 2012 and July 1st, 2013 were enrolled in this study. Patients were categorized into the following age groups: <50 years (Group I), 50-60 years (Group II), and >60 years (Group III). Adoption of the customized scleral device was assessed by the length of time the device was worn per day, the amount of time needed to insert and remove the device, the difficulty of device insertion and removal as determined by subjective difficulty scores (1= no difficulty; 5= very difficult), and whether or not an assistant was needed for device insertion or removal. Data was collected from daily logs kept by patients during the fitting process and by patient interview when logs were not available. The length of the fitting process and the number of trial devices needed to find a suitable fit were also recorded for each patient upon completion of the fitting process.

Results: Differences in the daily length of device wear across the three age groups were significant only during the first week of the fitting process with daily averages of 10±2.2 h for Group I, 5.0±5.2 h for Group II, and 2.8±2.0 h for Group III. Daily averages for all age groups exceeded 7 h by week 2 and 9 h by week 3. Device insertion times were below 5 minutes for the majority of patients in all groups within the first week of fitting (100% for Group I; 60% for Group II; 87% for Group III), and by week 3 for device removal (100% for Group I; 83%, for Group II; 100% for Group III). Mean subjective difficulty rating for device insertion and removal remained below 2 for all groups throughout the duration of the fitting process, and no assistance was needed for any patient in any group. There were no significant differences found in the length of the fitting process or the number of trial devices needed among the age groups.

Conclusions: Patients in all age groups quickly adapted to wearing the device and to its insertion and removal. Our study suggests that age should not be a major barrier in considering customized scleral device treatment such as PROSE.

Keywords: 477 contact lens • 479 cornea: clinical science