Abstract
Purpose
To report the use of a custom-designed, scleral contact lens (SL) in the treatment
of pediatric patients.
Methods
The medical records of all patients under 15 years of age fitted with SL from March
2018 through February 2020 were retrospectively reviewed. Ophthalmic diagnosis, prior
surgical intervention, lens wearing failures, and duration of lens use are reported.
Results
Lenses were dispensed to 18 patients (24 eyes). Main indications for SL fitting were
refractive error correction (n = 18: keratoconus (KCN), traumatic corneal scarring,
corneal transplant status, and aphakia) and ocular surface protection and optimization
(n = 6: neurotrophic keratitis and chronic blepharokeratoconjunctivitis). Patient
age ranged from 16 months to 14 years (mean, 9.9 ± 3.5 years (mean ± standard deviation
(SD)). Patients fitted for surface disease indications were significantly younger,
8.8 ± 2.5 years. The mean maximal keratometry reading in patients with keratoconus
was 64.0 ± 12.6 diopters (D). In six eyes with advanced KCN (Kmax 71.8 ± 11.0 D) and
three eyes with traumatic scarring, SL use obviated the need for keratoplasty. Fifteen
patients (83 %) continued scleral lens wear with a mean follow-up period of 9.2 ±
7.4 months. Complications included one case of corneal graft rejection and one corneal
abrasion associated with lens insertion.
Conclusions
The goals of SL fitting in pediatric patients are visual rehabilitation and ocular
surface protection. Pediatric patients with advanced keratoconus and traumatic corneal
scarring are most appreciative of the benefits of scleral lenses. The challenges associated
with SL fitting and the training process did not preclude long-term SL wear.
Keywords
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Article info
Publication history
Published online: May 01, 2021
Accepted:
April 27,
2021
Received in revised form:
April 26,
2021
Received:
January 19,
2021
Footnotes
☆Previously presented at: The Summit of Specialty Contact Lenses, Rome, Italy 06/2020 (virtual conference).
Identification
Copyright
© 2021 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
