Scleral lens for keratoconus: technology update

Figures & data

Figure 1 Corneal clearance on slit lamp biomicroscopy.

Note: Scleral lens (white arrow) with haptic resting on sclera and the space between the scleral lens and the cornea – corneal clearance (black arrow).

Table 1 Description of mini-scleral lenses available in the market

Name (manufacturer)	Diameter	Description
MSD (Blanchard Contact Lens Inc, Manchester, UK)	15.8 mm	Aspheric front surface and reverse geometry posterior surface with specially designed posterior and optical curves. Aspheric front surface reduces aberrations and improves vision
Jupiter (Visionary Optics, Front Royal, VA, USA) (Medlens Innovations, Front Royal, VA, USA/Essilor contact lens, Dallas TX, USA)	15.0–18.2 mm	Manufactured with focal point technology
Europa lens (Next generation of Jupiter scleral lens from Visionary Optics)	16.0–18.0 mm	Reverse geometry design with increased optic zone
Boston mini-scleral (Boston Foundation for Sight, Needham Heights, MA, USA)	15 mm and more	Custom-designed lenses using computerized lathe machine
Tru-scleral (Tru-Form Optics Inc, San Antonio, TX, USA)	16.0–20.0 mm	Have radial channels into periphery
Innovative sclerals	15.0–233.0 mm	Fitted on sag height of cornea

Abbreviation: MSD, mini-scleral design.

Figure 2 ASOCT in a patient with keratoconus with vault measured as 0.47 mm.

Note: The vault is more in periphery as compared to the center.
Abbreviation: ASOCT, anterior segment optical coherence tomography.

Figure 3 PROSE in keratoconus.

Notes: Scleral lens in keratoconus patient having intracorneal rings. The patient was referred for keratoplasty as he was not able to wear RGP lenses. With PROSE having FSE of 0.6, his visual acuity improved to 20/20.
Abbreviations: FSE, front surface eccentricity; PROSE, prosthetic replacement of the ocular surface ecosystem; RGP, rigid gas permeable.