Results of scleral lens treatment in keratoconus

The aim of this study was to evaluate the results of scleral contact lenses in different keratoconus groups. A total of 143 eyes of 90 patients who were prescribed scleral contact lenses and followed regularly in the 'Cornea and Contact Lens' unit of the Department of Ophthalmology, Harran University Faculty of Medicine, were retrospectively scanned. Firstly, the best corrected visual acuity without lens was measured in all patients and a detailed biomicroscopic examination and corneal topography were performed. After the appropriate scleral lens was selected and fitted, biomicroscopic examination with scleral lens, anterior segment optical coherence tomography imaging with scleral lens was performed at 1 hour and best corrected visual acuity was measured. A questionnaire (The Contact Lens Impact on Quality of Life (CLIQ) Questionnaire) was administered to the patients who were prescribed and started to wear scleral lenses at the 6th month control examination. Spearman correlation test, Kolomogorov-Smirnov test, Mann Whitney U test and Wilcoxon test were used for statistical analyses. Visual acuity with scleral lens was significantly improved compared to visual acuity without lens (p ˂ 0.05). It was found to be statistically significant that moderate and advanced keratoconus patients who underwent scleral lens treatment had more letter gain than mild keratoconus patients (p=0.013). According to the scleral lens brand used by the patients, there was an average of 6 snelllen letter row gain with both Air-Kone SKL and MiniMisa SKL and this increase was found to be significant for both lenses. According to the conus types, the highest row increase was realised in the globus type with 0.67. When we looked at the snelllen row increase according to the conus location, the highest visual increase occurred in the paracentral group. In conclusion, this study demonstrates that scleral lenses are a safe, effective and patient-satisfying option for the treatment of keratoconus. However, more information is needed on the long-term efficacy and safety of scleral lenses with long-term follow-up studies on larger patient populations. Future research will further strengthen the place of scleral lenses in the treatment of keratoconus.