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Impact of scleral lens wear intraocular pressure and posterior ocular perfusion

14 May 2019


Introduction: Scleral Lenses have been prescribed in contact lens arena for a long period of time since the history of the contact lens for many pathological conditions. These large diameter of gas permeable lenses land on different limbal and peri limbal margins. In recent years due to the comfort and its optimal visual performances these lenses have been widely prescribed in correction of normal refractive errors as well. In past few years few studies have shown increase in intraocular pressure of the eye with the use of scleral lens. Chronic exposure to increase in intraocular pressure (IOP) have shown to decrease in perfusion of blood in retinal layers leading to irreversible loss of the retinal cells. Optical coherence tomography (OCT) angiography is the most advanced and direct way of evaluation of retinal layers without the injection of the contrast dyes.

Purpose: To investigate the impact of the scleral lens wear on the intraocular pressure and posterior ocular perfusion through the measurement of the thickness profile of optic nerve head, retina and choroid.

Methods: Thirty-one healthy participants (20 to 31 years) underwent through battery of tests with Diaton for measurement of intraocular pressure and posterior ocular examinations with 4.5 X 4.5 mm scans centered on optic disc, 12 X 9 mm scan centered on macula and other areas of interest in retina with OCT angiography. Choroidal thickness at sub-foveal area, disc margin and at temporal area was measured with custom made software. Results were analyzed with mixed model and relevant bar graphs and scatter plots.

Results: Scleral lens wearers had significant increase in IOP (F= 109.77, p

Conclusion: Significant increase in IOP was seen with the 8 hours of scleral lens wear, decrease in peripapillary RNFL thickness may be important consideration for and considering OCT angiography parameters to be monitored for the scleral lens wearers in long term.

Keywords: optical coherence tomography, OCT angiography, optic nerve head, peripapillary retinal nerve fiber layer, intraocular pressure, scleral lens.


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