Medical Applications and Outcomes of Bitangential Scleral Lenses
To evaluate the clinical results of a new scleral lens design with a bitangential (nonrotationally symmetrical) periphery.
In this prospective cohort, evaluations were made of 18 unilateral eyes in patients who underwent CXL and had been wearing scleral lenses before the procedure. All the All the necessary data were obtained during the 1-year study period. The bitangential scleral lenses were fitted and monitored according to a standardized fitting methodology. They were cut by precise submicron lathing from high-oxygen-permeable materials (including 10 scleral lenses from Menicon Z material). Subjective performance, visual acu-ity, and scleral lensYfitting characteristics were recorded after a median of 9.4 weeks (range, 3 weeks to 1 year).
Diagnoses in the 213 eyes (in 144 patients) were keratoconus (n = 121 eyes; 56.8%), ocular surface diseases (n = 31 eyes; 14.6%), penetrating keratoplasty (n = 29 eyes; 13.6%), and other forms of irregular astigmatism (n = 28 eyes; 13.1%). Many patients (164 lenses; 77.0%) gave high ratings for comfort. The most common diameter was 20.0 mm (162 lenses; 76.1%) (range, 18.5 to 21.5 mm). Median decimal best-corrected visual acuity with the bitangential scleral lenses was 0.8 (equivalent to Snellen 20/25) (range, 0 to 1.5). Most bitangential scleral lenses showed good fitting characteristics: optimal values were seen for lens movement (208 lenses; 97.7%) and lens position (208 lenses; 97.7%). Median central corneal clearance was 0.2 mm; clearances differed in the four peripheral directions. The median stabilization axis was 140 degrees (range, 0 to 180 degrees) in the right eyes and 60 degrees (range, 0 to 180 degrees) in the left eyes.
The bitangential scleral lens fitting and performance characteristics were clear and effective for the health professional and the patient. The high-oxygen-permeable material Menicon Z may, in theory, be of benefit to corneas with a high oxygen demand.
The entire article was published in Optometry and Vision Science, Volume 90, No 3, 2013, pp. 1078-1085. Link to the article.
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