Clinical outcomes of scleral lenses in keratoconus: a systematic review and Meta-analysis

To evaluate the efficacy and safety of scleral lenses (SLs) in patients with keratoconus.

Electronic databases including PubMed, Scopus, Web of Science, Embase, and Cochrane Library were systematically searched to find the articles on visual function and patient satisfaction following SLs fitting. A random-effects model was applied to specify the pooled values.

Of 833 studies, 19 articles (704 eyes) and 14 studies (475 eyes) were included in qualitative and quantitative synthesis, respectively. Pooled mean difference (PMD) of best corrected visual acuity (BCVA) was -0.37 [95% confidence interval (CI), -0.48 to -0.26] logMAR in favor of SLs treatment. SLs markedly reduced ocular and corneal higher-order aberrations and increased the quality of vision. The overall pooled values for comfort, visual quality and patient satisfaction with SLs were 4.19 (95%CI, 3.83 to 4.55), 4.30 (95%CI, 3.97 to 4.64), and 80.83% (95%CI, 71.54% to 90.13%), respectively. The most reported complications were lens breakage (26.1%) and conjunctival injection (11.4%-15.8%).

SLs fitting leads to improved visual outcomes and patient satisfaction in patients with keratoconus.