SCLERAL LENSES: TOLERANCE AND EFFECTIVENESS IN KERATOCONUS.

The aim of our work is to evaluate the effectiveness and tolerance of scleral lenses in the management of keratoconus.

Contactology is a major pillar of visual rehabilitation in keratoconus. Scleral lenses are currently experiencing significant growth with the introduction of new materials that allow for excellent tolerance and easier fitting.

This is a prospective, monocentric study conducted at the ophthalmology department of CHU Habib Bourguiba in collaboration with the professional contactology center of Tunis, between July 1, 2023, and December 31, 2023, including cases of keratoconus referred for fitting with scleral lenses.

Fifty eyes of 28 patients with keratoconus were fitted with scleral lenses. The main indication for using scleral lenses was intolerance to other types of contact lenses, primarily RGP lenses, and this was the case for 13 patients. In second place was advanced keratoconus with low visual acuity in 12 patients. The fitting of scleral lenses was performed as the first option in 3 patients. The final visual acuity was significantly better than the initial visual acuity (p < 0.001), with a change from 0.7 to 0.15 logMAR. The subjective study of quality of life focused on 17 patients who received a renewal of scleral lenses. The average wearing time was 12 hours. Midday fogging was reported by 5 patients, conjunctival hyperemia by 7 patients, and dry eye by 9 patients. No inflammatory or infectious complications were noted, nor any complications related to hypoxia. Additionally, no cases of discontinuation of scleral lenses were observed.

Our study aligns with the conclusions of several recent studies, highlighting the effectiveness and tolerance of scleral lenses in the management of keratoconus.