Mini-scleral lenses improve vision, quality of life in patients with keratoconus
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Mini-scleral lenses improved visual functioning, visual acuity and socioemotional health in patients with keratoconus, according to a prospective, interventional study.
“Mini-scleral lenses offer not only improvement of visual acuity but also improvement of vision-related quality of life in patients with keratoconus,” first author Elke O. Kreps, MD, PhD, told Healio/OSN.
Patients who continued use saw statistically significant improvement of visual function.
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In the study, patients with keratoconus who visited contact lens clinics at Antwerp University and Ghent University hospitals in Belgium between June 2018 and July 2019 underwent a first-time mini-scleral lens fitting. Study candidates were excluded for previous corneal surgery, intellectual disability impairing questionnaire understanding, age younger than 18 years and ocular comorbidity limiting visual acuity.
Of 89 eyes of 50 patients, 47 eyes were fitted with mini Misa lenses (Microlens), 32 with mini Senso lenses (Procornea) and 10 with Zenlens (UCO).
Lens corrected visual acuity was recorded at follow-up visits at 2 months to 4 months. After 6 months, patients were called about continued use of the mini-scleral lenses. NEI VFQ-39 was readministered to those who continued use.
Of 11 patients who stopped mini-scleral lens use, seven reported difficulty inserting and removing lenses.
Statistically significant improvement of visual functioning and socioemotional scales (P < .0001) was noted in the 39 patients who continued use. Pretreatment median baseline logMAR of 0.22 was statistically significantly improved (P < .0001).
“In patients with very asymmetric keratoconus, lens fitting of the worse-fitting eye is mainly worthwhile when execution of near activities is impaired,” Kreps said.
Limitations included the short follow-up period, non-adjustment for quality-of-life factors such as socioeconomic status and education, and exclusion of pediatric patients.
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