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Muriel Schornack, Jennifer Harthan, Joseph T Barr, Ellen Shorter, Amy Nau, Cherie B Nau; Complications of Scleral Lens Wear. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1467.
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© ARVO (1962-2015); The Authors (2016-present)
Corneal rigid gas permeable lenses are associated with a low risk of complications. Although scleral lenses are also fabricated from rigid gas permeable materials, their unique fitting characteristics may give rise to a different complication profile. This study describes prescriber-reported complications associated with scleral lens wear.
A 19-question survey regarding scleral lens prescription and management practices was electronically administered by the Mayo Clinic Survey Research Center using Qualtrics (Provo, UT) from 1/12/15 to 3/31/15. Members of professional optometric and ophthalmologic organizations with self-reported interest in contact lenses were invited to participate via e-mail, and a link to the survey was included in two issues of a monthly contact lens-related international electronic newsletter. All identifying information was removed prior to data distribution and analysis. Respondents who had fit 5 or more patients with scleral lenses were asked to report the number of their patients who had experienced specific complications due to scleral lens wear.
A total of 989 individuals responded to the survey, of whom 723 reported fitting 5 or more patients. A total of 84,735 scleral lens patients were represented by these respondents. Corneal complications included edema (n=385, 0.45% of patients), neovascularization (n=238, 0.28% of patients), infiltrates (n=147, 0.17% of patients), toxic keratopathy (n=142, 0.17% of patients), bullae (n=86, 0.10% of patients), and microbial keratitis (n=70, 0.08% of patients). Conjunctival complications included giant papillary conjunctivitis (n=138, 0.16% of patients), conjunctivochalasis (n=16, 0.02% of patients) and hyperemia (n=11, 0.01% of patients). Other complications reported included limbal stem cell compromise (n=13, graft rejection (n=2), elevated intraocular pressure (n=1), uveitis (n=1) and retinal detachment (n=1). Handling error was reported as a cause of complication in 448 patients (0.53%).
Despite the fact that these lenses are often prescribed manage corneal and ocular surface disease, the overall incidence of complications associated with scleral lens wear appears to be low. Corneal complications, which could potentially threaten vision, were reported in 1.25% of patients represented by respondents to this survey. Conjunctival complications were reported in less than 0.05% of patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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