巩膜镜治疗严重眼表疾病的有效性和安全性

doi:10.6040/j.issn.1673-3770.0.2024.100

Abstract

Abstract: Scleral contact lens, commonly called scleral lens, is a new type of large-diameter, highly oxygen-permeable, rigid ocular surface contact lens that can cover the cornea, limbus and part of the sclera. Compared to the traditional rigid gas permeable(RGP)corneal contact lens, the scleral lens has a wide range of indications and can effectively reduce pain and irritation. It also has advantages in maintaining ocular surface hydration, promoting corneal epithelial repair and prolonging drug action. These properties enable it to demonstrate significant clinical efficacy in the treatment of ocular surface diseases such as keratoconus, dry eye, post-keratoplasty astigmatism, refractive errors, corneal degeneration or dystrophy and corneal trauma. What's more, scleral lenses can solve problems that are difficult to overcome with traditional RGPs. This article mainly provides a detailed summary of the treatment principles, efficacy and safety of scleral lenses in the treatment of ocular surface diseases, as well as the advantages and limitations of clinical treatment, with the aim of giving full play to their clinical therapeutic value.

Key words: Scleral lens, Eye surface diseases, Conus cornea, Dry eye disease, After corneal transplantation

CLC Number:

R778.3

LI Yuchen, WANG Xu. The efficacy and safety of scleral lenses in treating severe ocular surface disease[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 149-154.

References

[1] Bergmanson JPG, Walker MK, Johnson LA. Assessing scleral contact lens satisfaction in a keratoconus population[J]. Optom Vis Sci, 2016, 93(8): 855-860. doi:10.1097/OPX.0000000000000882
[2] El Bahloul M, Bennis A, Chraïbi F, et al. Scleral contact lenses: Visual outcomes and tolerance. A prospective study about 98 eyes[J]. J Fr Ophtalmol, 2021, 44(4): 549-558. doi:10.1016/j.jfo.2020.08.016
[3] Fadel D, Ezekiel DF. Fenestrated scleral lenses: back to the origins? review of their benefits and fitting techniques[J]. Optom Vis Sci, 2020, 97(9): 807-820. doi:10.1097/OPX.0000000000001562
[4] Fadel D, Kramer E. Potential contraindications to scleral lens wear[J]. Cont Lens Anterior Eye, 2019, 42(1): 92-103. doi:10.1016/j.clae.2018.10.024
[5] 钟宇玲, 薛劲松, 徐英男, 等. 巩膜镜的临床研究进展[J]. 国际眼科杂志, 2021, 21(12): 2109-2112. doi:10.3980/j.issn.1672-5123.2021.12.17 ZHONG Yuling, XUE Jinsong, XU Yingnan, et al. Clinical research advance of scleral lenses[J]. International Eye Science, 2021, 21(12): 2109-2112. doi:10.3980/j.issn.1672-5123.2021.12.17
[6] Schornack M, Nau C, Nau A, et al. Visual and physiological outcomes of scleral lens wear[J]. Cont Lens Anterior Eye, 2019, 42(1): 3-8. doi:10.1016/j.clae.2018.07.007
[7] Jedlicka J. Initial lens selection. Contemporary scleral lenses: theory and application Sharjah[J]. Bentham Science Publishers, 2017, 183-200. doi:10.2174/97816810856611170401
[8] Golebiowski B, Papas EB, Stapleton F. Corneal and conjunctival sensory function: the impact on ocular surface sensitivity of change from low to high oxygen transmissibility contact lenses[J]. Invest Ophthalmol Vis Sci, 2012, 53(3): 1177-1181. doi:10.1167/iovs.11-8416
[9] Chaudhary S, Ghimire D, Basu SY, et al. Contact lenses in dry eye disease and associated ocular surface disorders[J]. Indian J Ophthalmol, 2023, 71(4): 1142-1153. doi:10.4103/IJO.IJO_2778_22
[10] Ma F, Xu M, Qian YF, et al. Impact of long-term soft contact lens wear on epithelial flap production and postoperative recovery in laser-assisted subepithelial keratomileusis[J]. Acta Ophthalmol, 2015, 93(1): e67-73. doi:10.1111/aos.12499
[11] 付燕, 陈曦, 郑媛媛, 等. 角膜接触镜在眼部药物递送中的研究进展[J]. 中国现代医生, 2024, 62(12): 104-108. doi: 10.3969/j.issn.1673-9701.2024.12.025 FU Yan, CHEN Xi, ZHENG Yuanyuan, et al. Research progress of contact lens in ophthalmic drug delivery[J]. China Modern Doctor, 2024, 62(12): 104-108. doi: 10.3969/j.issn.1673-9701.2024.12.025
[12] Polania-Baron EJ, Santana-Cruz O, Lichtinger A, et al. Treatment of severe infectious keratitis with scleral contact lenses as a reservoir of moxifloxacin 0.5[J]. Cornea, 2021, 40(7): 831-836. doi:10.1097/ICO.0000000000002482
[13] Jacobs DS. Update on scleral lenses[J]. Curr Opin Ophthalmol, 2008, 19(4): 298-301. doi:10.1097/icu.0b013e328302cc4f
[14] 陈欣怡, 何婷, 沈婷. 眼部给药方式研究进展[J]. 国际眼科纵览, 2023, 47(3): 210-217. doi:10.3760/cma.j.issn.1673-5803.2023.03.003 CHEN Xinyi, HE Ting, SHEN Ting. Research progress on ocular administration methods[J]. International Review of Ophthalmology, 2023, 47(3): 210-217. doi:10.3760/cma.j.issn.1673-5803.2023.03.003
[15] Scanzera AC, Bontu S, Joslin CE, et al. Prevalence of ocular surface disease and corneal irregularity and outcomes in patients using therapeutic scleral lenses at a tertiary care center[J]. Eye Contact Lens, 2020, 46(6): 364-367. doi:10.1097/ICL.0000000000000679
[16] Pullum KW, Whiting MA, Buckley RJ. Scleral contact lenses: the expanding role[J]. Cornea, 2005, 24(3): 269-277. doi:10.1097/01.ico.0000148311.94180.6b
[17] Kreps EO, Pesudovs K, Claerhout I, et al. Mini-scleral lenses improve vision-related quality of life in keratoconus[J]. Cornea, 2021, 40(7): 859-864. doi:10.1097/ICO.0000000000002518
[18] 齐艳, 胡艳, 徐珊珊, 等. 巩膜镜矫正圆锥角膜的临床效果观察[J]. 中华眼视光学与视觉科学杂志, 2022, 24(5): 364-369. doi:10.3760/cma.j.cn115909-20210913-00383 QI Yan, HU Yan, XU Shanshan, et al. Clinical effect of the scleral lens in the treatment of keratoconus[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2022, 24(5): 364-369. doi:10.3760/cma.j.cn115909-20210913-00383
[19] Koppen C, Kreps EO, Anthonissen L, et al. Scleral lenses reduce the need for corneal transplants in severe keratoconus[J]. Am J Ophthalmol, 2018, 185: 43-47. doi:10.1016/j.ajo.2017.10.022
[20] DeLoss KS, Fatteh NH, Hood CT. Prosthetic Replacement of the Ocular Surface Ecosystem(PROSE)scleral device compared to keratoplasty for the treatment of corneal ectasia[J]. Am J Ophthalmol, 2014, 158(5): 974-982. doi:10.1016/j.ajo.2014.07.016
[21] Ling JJ, Mian SI, Stein JD, et al. Impact of scleral contact lens use on the rate of corneal transplantation for keratoconus[J]. Cornea, 2021, 40(1): 39-42. doi:10.1097/ICO.0000000000002388
[22] Serdarogullari H, Tetikoglu M, Karahan H, et al. Prevalence of keratoconus and subclinical keratoconus in subjects with astigmatism using pentacam derived parameters[J]. J Ophthalmic Vis Res, 2013, 8(3): 213-219.
[23] Navel V, Barriere JV, Joubert R, et al. Irregular astigmatism management using SPOT scleral lenses in the treatment of corneal ectasia and penetrating keratoplasty[J]. Eye Contact Lens, 2021, 47(7): 401-407. doi:10.1097/ICL.0000000000000792
[24] Scanzera AC, Deeley M, Joslin C, et al. Contact lens prescribing trends for keratoconus at an academic medical center: increased utilization of scleral lenses for severe disease[J]. Eye Contact Lens, 2022, 48(2): 58-62. doi:10.1097/ICL.0000000000000869
[25] Bavinger JC, DeLoss K, Mian SI. Scleral lens use in dry eye syndrome[J]. Curr Opin Ophthalmol, 2015, 26(4): 319-324. doi:10.1097/ICU.0000000000000171
[26] Carracedo G, Blanco MS, Martin-Gil A, et al. Short-term effect of scleral lens on the dry eye biomarkers in keratoconus[J]. Optom Vis Sci, 2016, 93(2): 150-157. doi:10.1097/OPX.0000000000000788
[27] La Porta Weber S, Becco de Souza R, Gomes JáP, et al. The use of the esclera scleral contact lens in the treatment of moderate to severe dry eye disease[J]. Am J Ophthalmol, 2016, 163: 167-173.e1. doi:10.1016/j.ajo.2015.11.034
[28] 麻凯, 李青松, 张振永, 等. 干眼症的物理治疗研究进展[J]. 国际眼科杂志, 2018, 18(4): 660-663. doi:10.3980/j.issn.1672-5123.2018.4.16 MA Kai, LI Qingsong, ZHANG Zhenyong, et al. Research progress in physical therapy for dry eye[J]. International Eye Science, 2018, 18(4): 660-663. doi:10.3980/j.issn.1672-5123.2018.4.16
[29] 刘洋, 赵少贞, 杨瑞波. 穿透性角膜移植术后的散光矫治[J]. 国际眼科纵览, 2016, 40(1): 36-40. doi:10.3760/cma.j.issn.1673-5803.2016.01.008 LIU Yang, ZHAO Shaozhen, YANG Ruibo. Management of postpenetrating keratoplasty astigmatism[J]. International Review of Ophthalmology, 2016, 40(1): 36-40. doi:10.3760/cma.j.issn.1673-5803.2016.01.008
[30] Shetty R, Lalgudi VG, Kaweri L, et al. Customized laser vision correction for irregular Cornea post-refractive surgery[J]. Indian J Ophthalmol, 2020, 68(12): 2867-2879. doi:10.4103/ijo.IJO_2793_20
[31] Manche E, Roe J. Recent advances in wavefront-guided LASIK[J]. Curr Opin Ophthalmol, 2018, 29(4): 286-291. doi:10.1097/ICU.0000000000000488
[32] Barnett M, Carrasquillo KG, Schornack MM. Clinical outcomes of scleral lens fitting with a data-driven, quadrant-specific design: multicenter review[J]. Optom Vis Sci, 2020, 97(9): 761-765. doi:10.1097/OPX.0000000000001576
[33] Chahal HS, Estrada M, Sindt CW, et al. Scleral contact lenses in an academic oculoplastics clinic: epidemiology and emerging considerations[J]. Ophthalmic Plast Reconstr Surg, 2018, 34(3): 231-236. doi:10.1097/IOP.0000000000000929
[34] van der Worp E, Bornman D, Ferreira DL, et al. Modern scleral contact lenses: a review[J]. Cont Lens Anterior Eye, 2014, 37(4): 240-250. doi:10.1016/j.clae.2014.02.002
[35] Fadel D. Scleral lens issues and complications related to a non-optimal fitting relationship between the lens and ocular surface[J]. Eye Contact Lens, 2019, 45(3): 152-163. doi:10.1097/ICL.0000000000000523
[36] Cheung AT, Hu BS, Wong SA, et al. Microvascular abnormalities in the bulbar conjunctiva of contact lens users[J]. Clin Hemorheol Microcirc, 2012, 51(1): 77-86. doi:10.3233/CH-2011-1513
[37] Shorter E, Schornack M, Harthan J, et al. Keratoconus patient satisfaction and care burden with corneal gas-permeable and scleral lenses[J]. Optom Vis Sci, 2020, 97(9): 790-796. doi:10.1097/OPX.0000000000001565
[38] Macedo-de-Araújo RJ, van der Worp E, González-Méijome JM. A one-year prospective study on scleral lens wear success[J]. Cont Lens Anterior Eye, 2020, 43(6): 553-561. doi:10.1016/j.clae.2019.10.140
[39] Fuller DG, Wang YR. Safety and efficacy of scleral lenses for keratoconus[J]. Optom Vis Sci, 2020, 97(9): 741-748. doi:10.1097/opx.0000000000001578
[40] Barnett M, Courey C, Fadel D, et al. Bcla clear-scleral lenses[J]. Contact Lens and Anterior Eye, 2021, 44(2): 270-288. doi.org/10.1016/j.clae.2021.02.001
[41] 蒋倩旎, 陈碧池, 周佳奇, 等. 巩膜镜与硬性透气性角膜接触镜矫正屈光不正的有效性及安全性比较[J]. 中华眼视光学与视觉科学杂志, 2023, 25(10): 777-783. doi:10.3760/cma.j.cn115909-20230306-00054 JIANG Qianni, CHEN Bichi, ZHOU Jiaqi, et al. The safety and efficacy of scleral lenses in the treatment of ametropia compared with rigid gas-permeable contact lenses[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2023, 25(10): 777-783. doi:10.3760/cma.j.cn115909-20230306-00054

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Comments

Recommended 0

No Suggested Reading articles found!

The efficacy and safety of scleral lenses in treating severe ocular surface disease

PDF (PC)

Abstract

Cite this article

share this article

References

Related Articles 2

Metrics

Comments

Recommended 0

[1]	LI YansongOverview,ZHU YuguangGuidance. Research progress on the effects of tear film stability on visual quality after phacoemulsification [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 19-25.
[2]	Huang Tianze, Chen Di,LI Ying. Advances of machine learning in the diagnosis of ocular surface diseases and guiding corneal surgical procedures [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 13-19.