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Amy Catherine Nau, Muriel Schornack, Jennifer Harthan, Cherie B Nau, Jennifer Swingle Fogt, Ellen Shorter; Fitting Efficiency of Impression-Based Scleral Lenses. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1481.
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© ARVO (1962-2015); The Authors (2016-present)
Therapeutic scleral devices derived from post -ocular surface impression digital processing provide an ideal scleral lens fit for complex surface topographies, providing an adequate mold is obtained. This goal of this study is to assess the efficiency of the fitting process for these highly specialized scleral devices.
An IRB approved, multi-center, retrospective chart review identified patients fit with impression-based scleral devices at three specialty contact lens practices between January 1, 2013 and June 30, 2019. Indications for wear, number of impressions, number of lenses, and number of visits needed to complete the fitting were determined. For patients wearing scleral lenses prior to being refit, the amount of time between discontinuation of standard scleral lens wear and acquisition of impressions was noted.
44 patients (70 eyes) fit with impression-based scleral devices were identified. Twenty-two patients wore traditional scleral lenses prior to being refit into impression-based lenses. Bilateral fits were undertaken in 26 patients, 18 patients were fit in one eye. An average of 1.3 [0.5] (mean [SD]) sets of impressions were required (range 1-3). Mean number of lenses ordered per eye was 2.1 [0.7] (range 1-5). Completion of the fitting process averaged 3.53 [1.5] visits (range 2-10). Comparing groups of patients with one, two, three or four co-morbid conditions with or without surgery, there was no difference between number of impressions, lenses or visits to achieve a fit. Data on the amount of time between discontinuation of standard scleral lens wear and acquisition of impressions was reported for 23 patients. Mean number of days between discontinuation of habitual lens wear and impression acquisition was 13.3 [36.9] (range 0-180 days). Duration of discontinuation did not make a difference in the number of impressions, lenses or visits.
In this population, 54% of patients suffered from more than one ocular surface condition, and 26 of the patients had undergone a surgical procedure, which often creates topographical abnormalities that challenge even the most experienced scleral fitters. In spite of this skewed population, the number of visits needed to complete the fitting process was comparable to that reported for diagnostically-fit scleral lenses for keratoconus alone.
This is a 2020 ARVO Annual Meeting abstract.
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