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Cherie B Nau, Muriel Schornack, Jennifer S Harthan, Amy Nau, Jennifer Swingle Fogt, Dingcai Cao, Ellen Shorter; SCOPE study: Experience of keratoconus patients wearing RGP or Scleral lenses. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1778.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate experience of patients with keratoconus wearing scleral lenses compared to those wearing rigid gas permeable lenses (RGP).
The SCOPE (Scleral lenses in current ophthalmic practice evaluation) group, with the support of the National Keratoconus Foundation (NKCF), distributed an online questionnaire through the NKCF website between October 2016 and March 2017. Respondents self-reporting the diagnosis of keratoconus (KC) were grouped according to their current optical correction in each eye. Continuous variables were compared using a paired t-test, and categorical variables were compared using a chi-square test.
422 people with keratoconus responded to the survey. 76 patients reported current bilateral scleral lens wear (age: 48 ±14 years, mean ±SD; range 15-82, n=75), while 75 patients reported current bilateral RPG lens wear (age; 52 ± 14 years, range 21-78 years, n= 73, p= 0.13). On a 0 (very dissatisfied) to 4 (very satisfied) scale, scleral lens wearers (n=75) were more satisfied with vision (3.21 ± 0.11) and comfort (3.25 ± 011), than RGP wears (n= 75; 2.63 ± 0.13,p=0.001 vision; 2.20 ± 0.1, p<0.001 comfort). There was no difference between ease of lens use(scleral 2.75 ± 013, RGP 2.75 ± 0.12, p=0.87). While scleral lens wearers estimated higher annual spending on keratoconus treatment ($2,201 ± 274, n=74) than RPG wearers ($1,563 ± 228, n=70) it was not statistically significant (p=0.08). Scleral lens wearers estimated spending more time per day on lens handling (9.5 ± 0.5 minutes, n=69) vs RPG wearers (7.3 ± 0.5 minutes, n=64, p=0.004). When asked if any symptoms had been experienced over the previous two years, scleral lens wearers (n=76) reported more halos (72% vs 53%, p = 0.15) and more difficulty applying or removing lenses (63% vs 40%, p =0.004) than RPG wears (n=75). RGP lens wearers reported more lens loss (40% vs 18%, p=0.004). Both groups reported equal difficulty seeing with their lenses (scleral 74% vs RPG 71%, p=0.68), cloudy vision (58% vs 63%, p=0.55), and discomfort (67% vs 77%, p=0.16).
Keratoconus scleral lens wearers have better vision and comfort with their lenses, and less lens loss than RGP lens wearers. Although both groups reported similar satisfaction with ease of lens use, scleral lens wears reported more difficulty with application and removal, and spend more time daily handling the lenses.
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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