Hypoxic Corneal Changes following Eight Hours of Scleral Contact Lens Wear

Optom Vis Sci. 2016 Mar;93(3):293-9. doi: 10.1097/OPX.0000000000000803.

Abstract

Purpose: To examine the change in corneal thickness and posterior curvature following 8 hours of miniscleral contact lens wear.

Methods: Scheimpflug imaging (Pentacam HR; Oculus) was captured before, and immediately following, 8 hours of miniscleral contact lens wear for 15 young (mean age 22 ± 3 years), healthy participants with normal corneae. Natural diurnal variations were considered by measuring baseline corneal changes obtained on a separate control day without contact lens wear.

Results: Over the central 6 mm of the cornea, a small but highly statistically significant amount of edema was observed following 8 hours of miniscleral lens wear, after accounting for normal diurnal fluctuations (mean ± standard deviation percentage swelling 1.70 ± 0.98%, p < 0.0001). Posterior corneal topography remained stable following lens wear (-0.01 ± 0.07 mm steepening over the central 6 mm, p = 0.60). The magnitude of posterior corneal topographical changes following lens wear did not correlate with the extent of lens-related corneal edema (r = -0.16, p = 0.57). Similarly, the initial central corneal vault (maximum post-lens tear layer depth) was not associated with corneal swelling following lens removal (r = 0.27, p = 0.33).

Conclusions: Although a small amount of corneal swelling was induced following 8 hours of miniscleral lens wear (on average <2%), modern high Dk miniscleral contact lenses that vault the cornea do not induce clinically significant corneal edema or hypoxic-related posterior corneal curvature changes during short-term wear. Longer-term studies of compromised eyes (e.g. corneal ectasia) are still required to inform the optimum lens and fitting characteristics for safe scleral lens wear to minimize corneal hypoxia.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Eye Segment / pathology
  • Contact Lenses / adverse effects*
  • Contact Lenses / statistics & numerical data
  • Cornea / pathology
  • Corneal Edema / etiology*
  • Corneal Pachymetry
  • Corneal Topography
  • Female
  • Healthy Volunteers
  • Humans
  • Hypoxia / etiology*
  • Male
  • Time Factors
  • Young Adult