A study of 530 patients referred for rigid gas permeable scleral contact lens assessment

The purpose of this study was to analyse the current application of scleral contact lenses in two specialist centres.

The case notes of 530 patients assessed for fitting or refitting with rigid gas permeable (RGP) scleral lenses were retrospectively analysed to determine the indication for contact lenses and the outcome. Scleral lenses had been offered as a conservative management option in suitable cases for a variety of visual and medical indications.

Various types of primary corneal ectasia, ranging from low grade to advanced, including keratoconus, keratoglobus, and pellucid marginal degeneration, formed 53.0% of the total referred for assessment. The other principal indications for contact lenses were corneal transplant (15.8%), aphakia (10.3%), high myopia (8.9%), and various ocular surface disorders (8.2%). Sixty percent continued to use scleral lenses, 42.9% RGP, and 17.1% polymethylmethacrylate lenses. Twenty-two percent discontinued scleral lens wear or failed a trial of scleral lenses, with 9.3% in progress at the time of assessment and 8.7% lost to follow-up.

In the authors' opinion, scleral lenses have retained their traditional role in the management of complex ametropia and ocular surface disease. That role has been further enhanced by the application of gas permeable materials.