Researchers recently found that patients who wear scleral contact lenses for keratoconus had a significantly lower risk of requiring keratoplasty, which may warrant the wide-scale use of sclerals for the condition. The team presented their findings Wednesday at the annual ARVO conference in Vancouver. 

Using the Sight Outcomes Research Repository, they identified 1,683 patients with keratoconus or corneal ectasia and no prior history of keratoplasty. Among these, 246 (14.6%) used scleral lenses and 103 (6.1%) underwent keratoplasty.

The researchers then evaluated potential risk factors for receiving a corneal transplant, including sociodemographic factors (age, gender, ethnicity, insurance status and community of residence) and use of scleral or rigid gas permeable (RGP) contact lenses, and tested the association between having these risk factors and receiving keratoplasty.

The team noted that 2.03% of patients wearing scleral lenses required keratoplasty, compared with 6.82% of those who did not wear scleral lenses. The use of a scleral lens was associated with a 72.7% decreased hazard of requiring keratoplasty. They add that other factors associated with an increased hazard of keratoplasty included black race (vs. white), younger age and lower socioeconomic status of a participant’s residential neighborhood. RGP use, gender and insurance status were not associated with receiving keratoplasty. 

“Without question, when compared with other forms of vision correction, scleral lenses have changed the treatment paradigm in managing patients with non-inflammatory thinning disorders, such as keratoconus, primarily because they provide exceptional comfort and vision,” says Joseph Shovlin, OD, of Northeastern Eye Institute in Scranton, PA. “Most transplants are a result of patients not achieving comfort or adequate vision with contact lens correction.”

Ling JJ, Mian S, Stein JD, et al. Impact of scleral contact lens use on risk of requiring corneal transplantation for keratoconus. ARVO 2019. Abstract 4779.