Abstract
Purpose :
To assess scleral lens settling (change in fluid reservoir/clearance) in four quadrants using novel ANTERION Swept-Source Optical Coherence Tomography (SS-OCT).
Methods :
A prospective observational clinical study of 29 subjects (30 eyes) was performed. Inclusion criteria included patients who were candidates for scleral lens fitting in at least one eye and over 18 years of age. All subjects were first time lens wearers. Patients who were pregnant were excluded. Subjects were separated into three categories: ocular surface disease (n=8), irregular cornea/scar (n=8) and corneal ectasia (n=15). Imaging was obtained at initial visit with ANTERION anterior segment SS-OCT, and then at follow-up visit with at least 4 hours of wear time to determine scleral lens settling. Using the Metrics app, 6 radial scans were obtained to allow visualization of scleral lens clearance centrally and in 12 clock hours around the periphery of the lens, grouped into four quadrants: superior (S), inferior (I), nasal (N), temporal (T). A perpendicular line from the posterior surface of the scleral lens to the corneal epithelium was manually drawn in ImageJ to determine the scleral lens clearance in microns, pre and post lens settling in the center and peripheral points 4.5 mm from the lens geometric center. Two lens designs were used (BostonSIGHT SCLERAL, n=21, and Visionary Optics Europa/Latitude, n=7) and a range of lens diameters (16.5mm to 18.5mm). Repeated measures ANOVA was performed comparing vault post minus pre differences by quadrant, and ANOVAs of lens design were performed comparing groups with significance threshold p < 0.05.
Results :
The mean central scleral lens settling was significant at -48.3 ± 41.7 µm. The scleral lens clearance by quadrant was S: -47.8 ± 67.3 µm, I: -68.0 ± 102.2 µm, N: -46.3 ± 63.4 µm and T: -56.7 ± 49.3 µm. There was no significant difference in lens settling between quadrants. Within the three categories, the irregular cornea group experienced significantly greater lens settling. There was no significant difference in central vault settling by lens design or lens diameter.
Conclusions :
The ANTERION SS-OCT allows for high resolution central and peripheral clearance assessment in scleral lens wear. Due to the increased technology available for scleral lens customization, this imaging modality can assist in more detailed assessment in quadrant-specific scleral lens designs.
This is a 2021 Imaging in the Eye Conference abstract.