Short-term Effect of Corneoscleral Contact Lenses in the Patients with Refractory Ocular Surface Diseases

Abstract

Purpose : To report the effect of corneoscleral contact lenses with a diameter of 14.0 mm for refractory ocular surface diseases.

Methods : Medical records of ten eyes of eight patients were retrospectively reviewed who were tried fitting with corneoscleral contact lenses (SoClear lens; Art Optical Contact Lens, Inc., Grand Rapids, MI, USA; total diameter = 14.0 mm) for the management of the refractory ocular surface diseases including Stevens-Johnson syndrome (SJS; six eyes) and chronic ocular graft-versus-host disease (GVHD; four eyes). Lenses were fitted to improve refractory sustained punctate epitheliopathy (nine eyes) and persistent epithelial defect (one eye with SJS) despite the proper medical management. Changes of the best corrected visual acuity (BCVA) and corneal staining score recommended by National eye institute (NEI), mean wearing time, and NEI’s Visual Function Questionnaire-25 (VFQ-25) were evaluated.

Results : Of the ten eyes, seven eyes were successfully fitted with the corneoscleral lenses. The fitting was failed in three eyes due to small palpebral fissure and shortened fornices (two eyes) and handling difficulty (one eye). For the seven eyes, follow up visits to complete fitting was once or twice, mean number of the ordered lens was 1.3 lenses (1-2). At one month follow-up after successful fitting, mean wearing time was 13.4 hours (12-17, all day long), NEI VFQ-25 score improved from 56.3 ± 24.5 to 64.63 ± 21.7, and there was no adverse event reported. For the six eyes with punctate epitheliopathy, BCVA improved from 0.13 to 0.07 in logMAR, corneal staining score improved from 6.50 to 4.17, and mean number of medication decreased from 4.17 to 1.83.

Conclusions : The corneoscleral lenses were successfully fitted in seven out of ten eyes and corneoscleral lenses can be helpful in the management of refractory ocular surface diseases in the well-fitted eyes.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.