Visual rehabilitation using SPOT^® scleral lenses in patients with keratoconus

IntroductionKeratoconus is a non-inflammatory corneal ectasia that leads to a reduction in visual acuity, often requiring visual rehabilitation with contact lenses.ObjectivesTo assess the impact of SPOT^® lenses on visual acuity improvement in patients with keratoconus, categorized by their stage according to the Amsler-Krumeich classification, and to analyze the correlation between disease stage and visual gain. Secondary objectives include evaluating visual acuity gain in patients who failed to adapt to the lenses, and in those with one or more corneal opacities.MethodsThis monocentric, retrospective, observational study included keratoconus patients treated at the CHU of Clermont-Ferrand. Patients underwent initial adaptation to SPOT^® lenses between June 2017 and June 2024. Exclusion criteria included ophthalmological conditions that could impair visual acuity.ResultsA total of 257 eyes from 150 patients were analyzed. Of these, 193 eyes fitted with SPOT^® scleral lenses were included in the primary analysis. The mean best-corrected visual acuity (BCVA) improved from 0.61 ± 0.59 -LogMAR before adaptation to 0.11 ± 0.14 -LogMAR after, with an average gain of 5 lines. Significant differences (p < 0.05) in visual acuity were observed across all stages, except between stages I and II before adaptation, and between stages I and II, and II and III after adaptation. Significant differences (p < 0.05) in visual acuity gain were found between each stage, except between stages I and II.ConclusionThe success of scleral lens adaptation is closely linked to improved visual acuity, particularly in the more advanced stages of the disease.