Effects of Scleral Contact Lenses for Keratoconus Management on Visual Quality and Intraocular Pressure

Figures & data

Table 1 Eyes Divided in 4 Groups Based on Krumeich Classification

n=60	K < 48D Stage I	K >48 <53D Stage II	K >53D <55D Stage III	K >55D Stage IV
Number of eyes with keratoconus at a specific stage	5	14	18	23

Abbreviations: n, sample size (eyes studied); K, keratometric measurements; D, diopters.

Figure 1 Slit-lamp examination of a patient’s eye fitting a scleral lens (Medlac 16.8mm diameter). It’s visible a thin tear layer between the posterior lens surface and the corneal apex.

Figure 2 Scleral lenses were inserted with preservative-free saline and sodium fluorescein, which helped the analysis of the tear allocation under the lens. The colored tear layer is homogeneous and air-bubbles free.

Table 2 Average IOP Obtained with GAT and DT Before, During and After Scleral CL Wear. Results are Expressed in Millimeters of Mercury Along with the Standard Deviation Value

n = 60 Eyes Affected by Keratoconus	GAT (Mean±Standard Deviation)	DT (Mean±Standard Deviation)
Without scleral CL	12.93 ±2.20	7.85 ±2.27
During scleral CL wear	Not evaluable	8.86 ±2.36
After scleral CL removal	12.85 ±2.40	7.66 ±1.88

Abbreviations: n, sample size; GAT, Goldmann applanation tonometry; DT, Diaton tonometry; CL, contact lenses.

Figure 3 Bland-Altman plot on Diaton tonometry vs Goldmann tonometry, before the scleral lens application (A) and after their removal (B). Dotted black lines show upper limits of agreement (ULOA) and lower limits of agreement (LLOA). Continuous black line shows mean difference. (A) mean: +5.15, ULOA: +7.8, LLOA: +2.5; (B) mean: +5.10, ULOA: +8.4 LLOA: +1.8. Diff: difference. Results are shown in mmHg.