Abstract
Purpose :
Scleral contact lenses (ScCL) are large diameter gas permeable contact lenses that enhance vision for a variety of ocular conditions. Several case reports have suggested ScCL can improve upper eyelid ptosis, but there have been no previous studies of the change in non-ptotic eyelid position with ScCL. In this observational clinical study, we hypothesize that ScCL wear increases interpalpebral fissure height (IPF) and margin to reflex distance (MRD).
Methods :
IPF and MRD were measured on 115 eyes of 64 established ScCL patients from photographs incorporating a millimeter ruler at three time points: before insertion of the ScCL (control), 5 minutes after insertion of the ScCL, and after 2 or more hours of ScCL wear. ScCL diameter and sagittal depth (sag) on eye, longevity of ScCL wear, patient sex and age, and reason for ScCL wear were documented for each subject and controlled for during statistical analysis. Sag of the ScCL on eye at the 2 hour time point was measured with Oculus Pentacam. The caliper tool available with the Scheimpflug images was used to measure the distance from the apex of the ScCL to a line bisecting the pupil. A linear mixed effects model was utilized for analysis of mean difference in IPF and MRD between time points.
Results :
Mean IPF of control conditions was 8.6±1.6mm. IPF measurement was greater after 5 min of ScCL wear than before ScCL placement (mean difference: 0.8mm, 95% CI 0.54, 1.06, p<0.001) and after 2 hours of ScCL wear than before ScCL placement (mean difference: 0.69mm, 95% CI 0.43, 0.95, p<0.001). There was no difference in IPF between 5 min and 2 hours of ScCL wear (mean difference: 0.11mm, 95% CI -0.15, 0.37, p=0.595). Mean MRD of control conditions was 3.4±1.4mm. MRD measurement was significantly greater after 5 min of ScCL wear than pre-ScCL insertion (mean difference: 0.35mm, 95% CI 0.14, 0.55; p<0.001) and after 2 hours of ScCL wear pre-ScCL insertion (mean difference: 0.28mm, 95% CI 0.08, 0.48, p<0.001). There was no significant difference in MRD between 5 min and 2 hours of ScCL wear (mean difference: 0.07mm, 95% CI -0.14, 0.27, p=0.732).
Conclusions :
Study findings support the hypothesis that ScCL wear increases IPF and MRD in eyes without ptosis.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.