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Scleral Contact Lenses: The Expanding Role

Purpose: The purpose of this study was to describe the current indications for scleral contact lens (ScCL) management at Moorfields Eye Hospital, London. Methods: A database of 1003 patients (1560 eyes) seen between September 1999 and May 2003, either assessed for an ScCL trial or to follow up previously issued lenses, was analyzed. Results: The major contact lens indication groups were keratoconus or other primary corneal ectasia (PCE), corneal transplant, and ocular surface disease (OSD). The 3 main small groups were aphakia, myopia, and ptosis. A total of 538 patients continued lens wear in 1 or both eyes, for a total of 808 eyes. The total numbers of eyes for each contact lens indication were PCE, 496 (61.4%); corneal transplant, 150 (18.6%); OSD, 91 (11.4%); aphakia, 17 (2.1%); myopia 21 (2.6%); ptosis 14 (1.7%); and a miscellaneous indication, 19 (2.2%). The percentages were similar to those of the total group of 1560 eyes. Seven hundred twenty lenses (89.1%) were rigid gas permeable (RGP), 708 were nonventilated, and 12 were fenestrated; 88 (10.9%) were ventilated polymethylmethacrylate or ptosis props. Conclusions: ScCLs continue to play a significant role in the management of corneal abnormalities, especially PCE, corneal transplant, and OSD. The great majority of lenses in use were nonventilated RGP designs.