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Jennifer S Harthan, Cherie B Nau, Muriel Schornack, Jennifer Swingle Fogt, Amy Nau, Ellen Shorter; Visual Outcomes with Scleral Lenses: a SCOPE Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1760. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe changes in best-corrected visual acuity before and after scleral lens prescription for patients.
The SCOPE (Scleral Lenses in Current Ophthalmic Practice Evaluation) study team conducted an online survey of contact lens prescribers between December 13, 2016 and March 31, 2017 with approval from the University of Illinois’ Institutional Review Board. Members of the Scleral Lens Education Society received direct e-mail invitations to participate in the survey, and links to the survey were included in two monthly online newsletters and were posted on the Scleral Lens Fitters Facebook page. Fitters were asked questions about the most recent established (> 6 months of lens wear) scleral lens patient they had evaluated. All surveys were anonymous and no identifiers were collected. Visual acuity was converted to logMAR for purposes of data analysis. Data was analyzed using paired t-test.
352 respondents completed the survey. There were 257 eyes (age 43 ± 13, mean ± SD, n=251) fit for corneal irregularity (keratoconus, pellucid marginal degeneration, post-surgical), 23 (age 60 ± 13) for ocular surface disease and 14 (age 40 ± 16) for refractive error. In patients with corneal irregularity, best-corrected visual acuity (BCVA) improved in the right eye from 0.39 ± 0.37 before lens wear to 0.09 ± 0.18 (n=175, p<0.001) with scleral lenses, and in the left eye from 0.38 ± 0.35 before lens wear to 0.08 ± 0.17 (n=181, p<0.001) with scleral lenses. Patients with ocular surface disease realized improvement in BCVA in both eyes; right eye from 0.35 ± 0.38 before lens wear to 0.09 ± 0.27 (n=18, p=0.02) with scleral lenses, left eye from 0.27 ± 0.28 (n=15) before lens wear to 0.06 ± 0.27 (n=16, p=0.003) with scleral lenses.Vision did not change for those with refractive error; right eye 0.14 ± 0.0.18 before lens wear to 0.04 ± 0.2 (n=9, p=0.08) with scleral lenses, left eye 0.09 ± 0.17 before lens wear to 0.00 ± 0.00 (n=8, p=0.2) with scleral lenses.
Visual acuity improved significantly for patients fit with scleral lenses for corneal irregularity (keratoconus, pellucid marginal degeneration, status-post penetrating keratoplasty and radial keratotomy), and for those with ocular surface disease. No significant improvements in visual acuity were noted in patients who wore scleral lenses for the correction of uncomplicated refractive error.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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