Abstract
Purpose :
Retrospective chart reviews and prospective observational studies have reported visual and physiological benefits of scleral lens (SL) wear but drop-out rates or reasons for which SL wear is abandoned are not well-documented. This study quantifies discontinuation of SL wear in a multicenter tertiary care center and enumerates reason(s) for discontinuation.
Methods :
A retrospective chart review was approved by the Mayo Clinic IRB. Records for patients for whom SL fitting was completed between June 15, 2006 and May 15, 2020 at one of three Mayo Clinic sites (MN, AZ, and FL) and who attended at least one follow-up evaluation after completion of fit were reviewed. Patient demographic information, indication for lens wear, duration of lens wear, lens wear status at most recent examination, and reason(s) for discontinuation of lens wear were recorded. Descriptive statistics are reported.
Results :
747 patients completed SL fitting and at least one follow-up evaluation. Mean [SD] patient age at the time of SL fitting was 53 [16.4] years (range 6-93 years); male/female distribution was 333/414. Primary indications for SL wear were corneal irregularity (CI)(51%, 383), ocular surface disease (OSD)(48%,356) and correction of refractive error (RE)(1%,8). Follow-up was 26 [33.7] (range 0.1-156.3) months. 32% (241) patients discontinued SL wear, including 26% of SL wearers with CI (98/383), 39% of SL wearers with OSD (140/356) and 38% of SL wearers with RE (3/8). Primary reasons for discontinuation of lens wear included: insufficient comfort (24%,57), insufficient visual improvement (16%,38), inability to apply/remove lens (15%, 36), change in management strategy (14%, 34), progression of ocular condition (4%,10), complication associated with SL wear (4%, 9), resolution of ocular condition (3%, 7), insufficient stability (<0.1%, 1), inability to pay for lens (<0.1%, 1), and other (5%, 12). Reason for lens discontinuation was not documented for 36 patients.
Conclusions :
Approximately 1/3 of patients discontinued SL wear. Higher percentages of patients with ocular surface disease or refractive correction discontinued lens wear compared to those with corneal irregularity. Insufficient comfort and visual improvement were the most cited reasons for SL discontinuation.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.