J Korean Ophthalmol Soc.  2016 Nov;57(11):1699-1705. 10.3341/jkos.2016.57.11.1699.

Fitting the Miniscleral Contact Lens in Patients with Corneal Abnormalities

• Suh SY
• Lee JH
• Lee SU
• Park YK
• Lee JS
• Lee JE

• KMID: 2357724
• DOI: http://doi.org/10.3341/jkos.2016.57.11.1699

Abstract

PURPOSE
To evaluate the clinical results of fitting the miniscleral contact lens (MSD; Happy Vision Corp., Anyang, Korea) in patients with corneal abnormalities.
METHODS
Thirty-eight patients (56 eyes) fitted with MSD lenses were recruited for this study. Clinical indication, visual acuity, degree of comfort, mean wearing time, parameters of the finally prescribed lenses, number of fittings with trial lenses, success rate with the first prescribed lens, and adverse events were evaluated.
RESULTS
Forty-two (75%) of 56 eyes were enrolled in this study due to keratoconus. Other conditions included Stevens-Johnson syndrome (6 eyes, 11%), high postkeratoplasty astigmatism (3 eyes, 5%), corneal scarring (3 eyes, 5%), and ectasia after laser in situ keratomileusis (LASIK; 2 eyes, 4%). The mean log MAR visual acuity improved from 1.01 ± 0.64 to 0.13 ± 0.19 after wearing lenses (p= 0.0001). In 53 eyes (94.6%), patients reported the miniscleral contact lenses to be comfortable, and the mean daily wear time was 12.9 ± 2.5 hours. The mean sagittal depth of finally prescribed lenses was 4.67 ± 0.37 mm (3.7-5.4). An average of 3.3 ± 1.5 (1-7) trials were needed for the trial fitting, and the average number of re-prescriptions to achieve the optimal fitting was 1.5 ± 0.48 (1-3). One patient discontinued the lenses after 3 months due to discomfort.
CONCLUSIONS
Miniscleral contact lenses are a good alternative for patients with corneal abnormalities and result in both successful visual outcome and comfort.

Keyword

Corneal abnormalities; Miniscleral contact lens; Scleral lens fitting

MeSH Terms

Astigmatism
Contact Lenses
Corneal Injuries
Dilatation, Pathologic
Gyeonggi-do
Humans
Keratoconus
Keratomileusis, Laser In Situ
Stevens-Johnson Syndrome
Visual Acuity

Figure

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  Figure 1. Corneal clearance after fitting of miniscleral contact lens. Optical coherence tomography section was used to define precorneal tear reservoir thickness profile compared with lens thickness. The central thickness of miniscleral lenses ranges from 250 μm to 350 μm.

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  Figure 2. Three different landing zone designs. (A) Too steep curve, (B) proper curve, and (C) too flat curve. Larger blood vessels may be impeded by a steep curve (A) and too flat curve (C) makes conjunctival vessels at the lens edge broken, which can cause lens awareness and discomfort compared to the proper curve (B).

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  Figure 3. Change in best-corrected visual acuity between corneal rigid gas permeable contact lenses or glasses and miniscleral contact lenses. Points lying above the solid 45° line correspond to eyes with improved vision with miniscleral contact lenses.

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  Figure 4. Distribution of self-reported assessment of miniscleral contact lens comfort. The Mini Scleral Design (MSD) lenses were very comfortable in 28 eyes (50.5%), comfortable in 25 eyes (44.1%) and mildly irritating in 3 eyes (5.4%) of all 56 eyes.

Reference

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