Perspective from Satya B. Verma, OD, FAAO
Source:

Walker MK, et al. Optom Vis Sci. 2020;doi:10.1097/OPX.0000000000001567

Disclosures: The authors report no relevant financial disclosures. This work was supported by grants from the NIH and University of Houston.
April 20, 2021
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Study suggests no significant impact of scleral lens wear on IOP in healthy eyes

Perspective from Satya B. Verma, OD, FAAO
Source:

Walker MK, et al. Optom Vis Sci. 2020;doi:10.1097/OPX.0000000000001567

Disclosures: The authors report no relevant financial disclosures. This work was supported by grants from the NIH and University of Houston.
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An investigation involving healthy adult eyes naïve to scleral contact lens wear identified a minimal effect on IOP homeostasis and optic nerve morphology after wearing lenses.

“With evidence of adverse events and considering the diseased eyes for which they are indicated, it is imperative to understand both the positive and negative ocular health impacts of scleral lenses,” Maria Walker, OD, MS, FAAO, of the University of Houston College of Optometry, and colleagues wrote in Optometry and Vision Science.

Walker and colleagues conducted an experiment of 26 “healthy scleral lens neophytes.” Potential participants were excluded if they had a history of glaucoma, hypertension or ocular surgery and if their IOP measured greater than 20 mm Hg in either eye upon enrollment.

The final analysis included 52 eyes from 26 patients with a mean central corneal thickness of 540 m before lens wear. Participants were between 23 and 33 years old, with the majority (81%) being female.

Participants wore scleral lenses for 6 hours in one randomly selected eye, and the other eye was the control. At the 2- and 6-hour marks, global minimum rim width, IOP, central corneal thickness, anterior chamber depth and fluid reservoir depth were monitored.

The investigation identified minimum rim width thinning in test (8 m) and control eyes (6 m) after 6 hours of lens wear, with minimal difference in thinning. Mean IOP increased in test eyes (P = .002) with no change in control eyes. Investigators reported “no clinically significant changes in central corneal thickness or anterior chamber depth.

“This study suggests that scleral lenses have a relatively small effect on IOP in the normal eye, and that any impacts of pressure fluctuation on the optic nerve are likely not significant for young, healthy eyes,” the researchers wrote. “The long-term effects of scleral lenses on IOP and optic nerve head structure, especially in susceptible eyes, should be investigated.”