Comparison of the influence of corneo-scleral and scleral lenses on ocular surface and tear film metrics in a presbyopic population. Issue 1 (February 2018)

• Record Type: Journal Article
• Authors: Lafosse, Edouard; Romín, Daniel Monsálvez; Esteve-Taboada, José-Juan; Wolffsohn, James S.; Talens-Estarelles, Cristian; García-Lázaro, Santiago
• Is Part Of: Contact lens & anterior eye. Volume 41:Issue 1(2018)
• Page Start: 122
• Page End: 127
• Publication Date: 2018-02
• Subjects: Corneo-scleral lens -- Scleral lens -- Ocular surface -- Presbyopia -- Tear film; Anterior segment (Eye) -- Periodicals; Contact lenses -- Periodicals; Segment antérieur (Œil) -- Périodiques; Lentilles de contact -- Périodiques; 617.752305
• DOI: 10.1016/j.clae.2017.09.014
• Languages: English
• ISSNs: 1367-0484

Abstract

Highlights: Scleral (Scl) & semi-scleral (C-Scl) contact lenses can protect ocular surface. Impact of Scl & C-Scl of same material on tear film & physiology compared. Presbyopic patient tear film metrics are impacted by scleral lens diameter. C-ScL provides better tear meniscus area, corneal thickness & osmolarity than Scl. Hence C-Scl option for dry eye patients. Abstract: Purpose: To assess and compare the effect of the corneo-scleral lenses (C-ScL) and scleral lenses (ScL) on tear film parameters and central corneal thickness (CCT) in healthy presbyopic subjects. Methods: Thirty subjects wore two contact lenses (CLs), randomly assigned, of neutral power, but of different diameters, 12.7 mm (C-ScL) and 18 mm (ScL) and being equal in the others parameters: material (HS100) and centre thickness (0.29 mm). At baseline, 20 min after insertion and at 8 h, the tear meniscus area (TMA) and CCT was measured (with optical coherence tomography) as well as tear osmolarity. Results: TMA revealed statistical differences for both lenses at 20 min (p < 0.001), and also at 8 h (p = 0.003), being greater for the C-ScL. CCT showed statistical differences for both lenses at 20 min (p = 0.002), and also at 8 h (p = 0.001), being lower for the C-ScL. Osmolarity did not reveal statistical differences at 20 min (p = 0.29), while it was statistically different at 8 h (p = 0.03), being lower for the C-ScL. Conclusions: C-ScL lead to a lesser reduction in the TMA and a lower induced hypoxic stress than the ScL. Osmolarity levels remained within normal values across the day with no clinical difference between lenses. Both designs can represent a good optical platform for correcting presbyopia as well as protecting the ocular surface by vaulting the cornea.