Scleral lenses can be challenging for patients, especially new wearers, considering their advanced insertion and removal regimen. Not surprisingly, a research team found the main reasons behind scleral lens dropout were handling issues and discomfort. Still, a majority of patients in their study (73%) were able to successfully wear their lenses for the entire year-long investigation period, and as time progressed, they became more adept at applying the lenses.
The study included 95 participants who were divided into two groups: 71 test subjects with irregular corneas and a control group of 24 patients with regular corneas. Patients in both groups were examined at baseline, at a lens dispense visit and at one month, three months, six months and 12 months. The researchers factored in the number and cause of scleral lens dropouts and the amount of time it took the patients to apply the lenses during the follow-up visits. Patients also answered a questionnaire about wear time, lens handling and number of attempts to correctly apply and remove the lenses.
The researchers reported 69 participants (73%) successfully wore the lenses for the 12-month period, while 27% discontinued scleral lens wear. None of the dropouts were due to adverse events, the study noted.
The success rate—defined as the number of participants who wore the lenses for 12 months—was 77% in the irregular cornea group and 58% in the control group. The investigators found the main reasons behind scleral lens dropout were handling issues at 35% followed by discomfort at 19%.
Looking at the length of time it took patients to apply their lenses, 36% needed less than 15 minutes during the lens dispense visit. However, 13% required more than 60 minutes. These included participants who wore spectacles or soft lenses or had no correction method at baseline, researchers noted.
Over time, participants who continued to wear the lenses developed increased handling skills.
Wearing time also increased significantly from the one-month to the 12-month appointments: 9.8 hours compared with 11.1 hours a day, respectively, and from 5.1 days a week to 5.6 days a week at the end of the study period. Researchers also found a significant decrease in the number of attempts to correctly apply and removes the lenses over time.
|Macedo-de-Araújo RJ, van der Worp E, González-Méijome JM. A one-year prospective study on scleral lens wear success. Cont Lens Anterior Eye. November 13, 2019. [Epub ahead of print].