Posters

Management of severe corneal scarring and ocular surface disorders with scleral lenses

Poster Details

First Author: D.Spourdalakis GREECE

Co Author(s):    D. Spourdalakis   S. Palioura                 

Abstract Details

Purpose:

To describe our clinical experience with scleral contact lenses in cases of severe ocular surface disease.

Setting:

Tertiary referral opthalmology clinic.

Methods:

A retrospective chart review performed from February 2018 to February 2020 identified 5 patients with severe ocular surface disease that were fitted with scleral lenses at Athens Vision Eye Institute. Before scleral lens fitting all patients wore therapeutic soft contact lenses (SCLs). The post-lens fluid reservoir was always filled with non-preserved sterile saline. Scleral lenses were worn on average 10 hours per day.

Results:

Two patients had chronic sequelae of Stevens–Johnson syndrome such as lid margin keratinization and limbal stem cell deficiency (LSCD) and one had history of LSCD due to a binocular severe thermal burn status post allogeneic simple limbal epithelial transplantation. Two patients were monocular, one with history of toxic keratopathy and persistent epithelial defects status post multiple amniotic membrane transplantations and one with severe post-infectious corneal thinning. Prior to scleral lens fitting, the best corrected visual acuity (BCVA) of the aforementioned 5 patients ranged from 20/50 to count fingers. Following scleral lens fitting, BCVA improved by at least 3 lines in all cases. Four patients had to refill the lens reservoir at least once a day to prevent lens fogging. The two SJS patients still wore therapeutic SCLs at night to minimize corneal microtrauma during sleep.

Conclusions:

Scleral lenses provide a non-invasive means to achieve better vision, improve comfort and protect the ocular surface in advanced ocular surface disease. An individualized approach to each patient is warranted.

Financial Disclosure:

None