Abstract
Purpose :
Survey research has defined primary indications for scleral lens wear as corneal irregularity (74%), ocular surface disease (16%), and uncomplicated refractive error (10%). Data on secondary indications or specific conditions for lens wear have not been systematically reported. This multicenter study reports primary and secondary indications and specific conditions for which scleral lenses were prescribed within a single health care system from 2006 through 2019.
Methods :
A retrospective chart review collected demographic information, primary and secondary indications for scleral lens wear, and specific conditions treated of patients who completed scleral lens fitting from 2006 through 2019. Descriptive statistics are reported.
Results :
Scleral lenses were prescribed for 850 patients. The mean age at the time of scleral lens fitting was 53.5 [16.4] years of age (range 6-93 years). Male/female distribution was 372/478. Primary indications were corneal irregularity (434 patients, 51%), ocular surface disease (407 patients, 48%) and refractive error (9 patients, 1%). The numbers of patients with specific conditions causing corneal irregularity were: keratoconus (138), S/P keratoplasty (87), S/P RK (56), S/P LASIK (42), S/P trauma (30), S/P keratitis (29), pellucid marginal degeneration (22), S/P PRK (7), Terrien’s marginal degeneration (2), unspecified corneal scarring (9), and unspecified irregular astigmatism (12). The numbers of patients with specific ocular surface conditions were: exposure keratopathy (103), unspecified dry eye syndrome (89), neurotrophic keratopathy (58), chronic GvHD (53), Sjogren syndrome (34), Salzmann degeneration (18), cicatrizing conjunctivitis (16), anterior basement membrane dystrophy (11), dry eye syndrome related to refractive surgery (11), limbal stem cell deficiency (11), congenital disorder (2), and superior limbic keratoconjunctivitis (1). A secondary indication was noted for 129 (30%) patients with corneal irregularity. A secondary indication was noted for 87 (21%) patients with ocular surface disease. A secondary indication was noted in only 1 patient with refractive error.
Conclusions :
Ocular surface disease was the primary indication for lens wear in almost 50% of patients within this cohort, compared to less than 20% in previous studies. A secondary indication for scleral lens wear was noted in 20-30% of these patients, which may suggest that complex disease can be managed with scleral lenses.
This is a 2021 ARVO Annual Meeting abstract.