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Review
. 2015 Oct 28:9:2013-8.
doi: 10.2147/OPTH.S52483. eCollection 2015.

Scleral lens for keratoconus: technology update

Varsha M Rathi  1 , Preeji S Mandathara  2 , Mukesh Taneja  1 , Srikanth Dumpati  1 , Virender S Sangwan  1
Affiliations
Review

Scleral lens for keratoconus: technology update

Varsha M Rathi et al. Clin Ophthalmol. .

Abstract

Scleral lenses are large diameter lenses which rest over the sclera, unlike the conventional contact lenses which rest on the cornea. These lenses are fitted to not touch the cornea and there is a space created between the cornea and the lens. These lenses are inserted in the eyes after filling with sterile isotonic fluid. Generally, scleral contact lenses are used for high irregular astigmatism as seen in various corneal ectatic diseases such as keratoconus, pellucid marginal degeneration, or/and as liquid bandage in ocular surface disorders. In this article, we review the new developments, that have taken place over the years, in the field of scleral contact lenses as regard to new designs, materials, manufacturing technologies, and fitting strategies particularly for keratoconus.

Keywords: PROSE; keratoconus; scleral lens; technology update.

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Figures

Figure 1
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).
Figure 2
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
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.
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