Abstract
Purpose :
To report on visual performance over time with traditional scleral lens (tSL) and wavefront-guided scleral lenses (wfgSL) in patients with keratoconus (KC).
Methods :
11 eyes of 8 patients diagnosed with KC were fit with a tSL. After the tSL was finalized, a comprehensive wavefront aberrometry system (X-Wave, Ovitz, Rochester, NY) was used to create a wfgSL (ARES, Ovitz, Rochester, NY). A crossover was performed, best-corrected lens visual acuity (BCLVA) and total higher-order root mean square (HORMS) were compared between the tSL and wfgSL at dispense and after 1-month of lens wear.
Results :
When comparing wfgSL to tSL, at dispense, there was a 0.1 ± 0.1 logMAR (p < 0.01) improvement in BCLVA and a 0.58 ± 0.29 µ (p < 0.01), a 49 ± 13% improvment in HORMS. At 1-month follow-up there was a 0.2 ± 0.1 logMAR improvement (p < 0.01) in BCLVA and a 0.54 ± 0.20 µm (p < 0.01), a 48 ± 9% improvement in HORMS. No eyes lost lines of visual acuity at dispense or at the 1-month follow-up.
At dispense of the wfgSL, 3 of 11 eyes showed no improvement in BCLVA. At 1-month follow-up, all 3 eyes showed a 0.1 logMAR improvement without additional improvement in HORMS.
Of note, at the dispense of the wfgSL, 1 of the 11 eyes showed a 0.1 logMar improvement in BCLVA, and at the 1-month follow-up, the same eye showed an additional 0.3 logMar lines and a 0.22 µ, 12% improvement in HORMS. Post analysis of this improvement correlated to lens malposition at dispense and correct positioning at the 1-month follow-up.
Conclusions :
When compared with tSL, wfgSL reduced HORMS and improved BCLVA. One month after initiating wfgSL wear, BCLVA continued to improve at the follow-up visit without change in HORMS. This improvement is likely secondary to neural adaptation to wfgSL optics. Further studies are needed to understand the role of neural adaptation in wfgSL.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.