June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Visual and Physiological Outcomes of Impression-Based Scleral Lens Wear
Author Affiliations & Notes
  • Muriel Schornack
    Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
  • Amy Catherine Nau
    Korb and Associates, Massachusetts, United States
  • Jennifer Harthan
    Illinois College of Optometry, Illinois, United States
  • Ellen Shorter
    University of Illinois at Chicago, Illinois, United States
  • Cherie B Nau
    Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
  • Jennifer Swingle Fogt
    School of Optometry, The Ohio State University, Ohio, United States
  • Footnotes
    Commercial Relationships   Muriel Schornack, None; Amy Nau, Avedro (F), Johnson & Johnson (F); Jennifer Harthan, Allergan (F), Essilor (F), Kala (F), Metro (F), Shire (F), Synergeyes (F), Takeda/Novartis (F), Tangible Science (F); Ellen Shorter, Johnson & Johnson (F); Cherie Nau, None; Jennifer Fogt, Alcon (F), Contamac (F), EyeLab (F), Innovega (F), Nevakar (F), NovaSight (F), Ocugen (F), Shire (F)
  • Footnotes
    Support  Unrestricted grant from Research to Prevent Blindness, University of Illinois at Chicago
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 1476. doi:
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      Muriel Schornack, Amy Catherine Nau, Jennifer Harthan, Ellen Shorter, Cherie B Nau, Jennifer Swingle Fogt; Visual and Physiological Outcomes of Impression-Based Scleral Lens Wear. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1476.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Impression-based scleral lenses are manufactured to exactly match anterior ocular surface contour. This exact match should eliminate lens decentration and induced vector forces on the cornea, which should optimize fit, visual acuity and comfort. Furthermore, precise alignment between the lens haptic and ocular surface should reduce the risk of ocular surface compromise. This study assessed the visual and physiological outcomes of patients fit with impression-based scleral lenses.

Methods : A multi-center retrospective chart review identified patients fit with impression-based scleral lenses at three specialty contact lens practices between January 1 2013 and June 30 2019. Visual acuity was recorded prior to as well as after impression-based lens fitting. In addition, the presence or absence of corneal and conjunctival staining was noted before and after impression-based lens wear.

Results : A total of 44 patients (70 eyes) who had been fit with impression-based scleral lenses were identified. Twenty-six patients were fit bilaterally, OD only was fit in 9 patients, and OS only was fit in 9 patients. Nine patients wore no correction prior to impression-based lens fitting, 5 wore a combination of spectacles and contact lenses, 7 wore spectacles only, and 23 wore contact lenses. The habitual correction logMAR acuity was 0.40 [0.56] (mean [SD]) significantly improving to logMAR acuity 0.22 [0.44] with impression-based lenses (n=69, p<0.01). The presence or absence of corneal staining was noted for 65 eyes and the presence or absence of conjunctival staining was recorded for 55 eyes. Corneal staining was present in 28 eyes prior to impression-based scleral lens fitting and remained in 22 eyes after fitting. Conjunctival staining was present in 22 eyes prior to impression-based scleral lens fitting and was persistent in 20 eyes after fitting.

Conclusions : Visual acuity with impression-based lenses improved significantly compared to baseline with habitual correction. However, improvement in visual acuity was similar to that which has been reported with standard scleral lens designs. While the number of eyes with corneal or conjunctival staining decreased slightly with impression-based lenses, a majority of eyes that exhibited staining prior to impression-based lens wear continued to show staining after being fit with these lenses.

This is a 2020 ARVO Annual Meeting abstract.

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