Scleral lens induced short term corneal changes in eyes with Pellucid Marginal Degeneration

Ronit Dutta; Geetha Iyer; Bhaskar Srinivasan; Asif Iqbal

doi:10.1016/j.clae.2024.102173

Scleral lens induced short term corneal changes in eyes with Pellucid Marginal Degeneration

Cont Lens Anterior Eye. 2024 Apr 22:102173. doi: 10.1016/j.clae.2024.102173. Online ahead of print.

Authors

Ronit Dutta¹, Geetha Iyer², Bhaskar Srinivasan², Asif Iqbal³

Affiliations

¹ Department of Contact Lens, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India.
² CJ Shah Cornea Services, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India.
³ Department of Contact Lens, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India. Electronic address: iqbalasif2007@gmail.com.

PMID: 38653594
DOI: 10.1016/j.clae.2024.102173

Abstract

Purpose: To investigate the short-term effect of scleral lens (SL) on corneal curvature and corneal oedema in Pellucid Marginal Degeneration (PMD) eyes.

Methods: Corneal anterior, posterior curvature and corneal thickness were measured in 14 eyes of 14 PMD participants with Schiempflug imaging at different corneal diameters and meridians at baseline and after 6 h of SL wear.

Results: There was a significant flattening (up to 0.26 mm) of the anterior corneal curvature noted in the inferotemporal quadrant (from 210 to 255 degree at 2 mm, 8 mm and 10 mm corneal diameter), inferonasal quadrant (from 285 to 345 degree at 6 mm and 8 mm corneal diameter), and inferiorly at 2 mm and 10 mm corneal diameter (p < 0.05). Similarly, posterior corneal curvature showed statistically significant steepening mostly in inferotemporal quadrants (from 195 to 255 degree from 4 mm to 8 mm corneal diameter) and inferonasally at 2 mm and 4 mm corneal diameter (p < 0.05). A statistically significant increase in the corneal thickness noted in different corneal diameters with corneal oedema ranging from 2.10 % to 4.00 % after 6 h of SL wear. A gradual increase in corneal oedema was noted form centre to periphery. The baseline central fluid reservoir thickness (FRT) was 341.07 ± 139.8 which reduced to 276.71 ± 114.32 µm after 6 h of lens wear. No significant correlation was noted between corneal oedema with different parameters like initial and final FRT, change in anterior and posterior corneal curvature, and lens thickness (p > 0.05).

Conclusions: Short-term SL wear induced a clinically acceptable range of corneal oedema. A clinically significant flattening in anterior curvature and minimal steepening in posterior curvature were noted. Practitioners should be careful while measuring corneal parameters in PMD eyes wearing SL, as these alterations can provide false impression of disease progression.

Keywords: Corneal curvature; Corneal oedema; Corneal thickness; Fluid reservoir thickness; Pellucid marginal degenerations; Scleral lens.