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Advances in scleral lenses for refractive surgery complications

Purpose of review The last two decades have brought advances in materials and manufacturing of large diameter rigid gas-permeable contact lenses, and a greater appreciation of the role of scleral lenses for therapeutic indications. The purpose of this review is to provide an update on the use of rigid gas-permeable scleral lenses in the management of patients with complications after refractive surgery. Recent findings There are recent reports on clinical experience with specific scleral lens designs from single institutions in cohorts that include patients who have undergone refractive surgery. Typically, these are patients with ‘irregular corneas’ after radial keratotomy or LASER assisted in-situ keratomileusis, but patients with keratectasia, dry eye syndrome, and corneal neuralgia are also reported. Visual outcomes and wearing success rates are high in these reports, although outcomes for refractive surgery patients are not reported separately. Summary Clinicians who encounter patients with complications after corneal refractive surgery should be aware of advances in scleral lenses. Scleral lenses are an alternative to surgical intervention in patients who might otherwise be considered poor contact lens candidates.