Scleral Lenses in Corneal Opacities

Objective: To describe vision-correction benefits of gas-permeable scleral contact lenses in the management of corneal opacities.

Materials and Methods: Fourteen patients (15 eyes) with corneal opacities were referred initially for corneal graft. Butdue to the lack of grafts, we proposed scleral lenses for vision correction as a temporary solution.

Results: The most common indication for lenses fitting was keratoconus with opacity in patients who had to stop wearing other types of corneal lenses and referred for corneal graft (8 eyes). Other indications included interstitial keratitis, herpetic keratitis, ocular scars from Stevens-Johnson syndrome and acid burn. Mean follow-up period was 14 months (2-24). The opacity was central in 9 patients and paracentral in 5. Mean use time of scleral lenses was 12 hours per day. Average logMAR visual acuity without correction and with lenses was 1,7 and 0,3 respectively. A gain of three or more Snellen lines was observed in 92,85% of eyes. The scleral lenses were well tolerated in all patients. One patient had problems with lenses manipulation. The scleral lenses had no effect on the evolution of the opacities.

Conclusion: Gas permeable scleral lenses provide successful visual solutions for corneal opacity when corneal grafts are not available.

Keywords: scleral lenses; opacity; cornea.