Fluid-filled scleral contact lenses in vernal keratoconjunctivitis.

OBJECTIVES

The purpose of this study is to report on the use of fluid-filled scleral contact lenses (F-ScCL) in patients with vernal keratoconjunctivitis (VKC).

METHODS

We retrospectively reviewed charts of four patients who had worn F-ScCL (PROSE, Boston Foundation for Sight, Needham Heights, MA) from July 2006 for VKC with two associated conditions; keratoconus and limbal stem-cell deficiency (LSCD). Any previous refractive correction or complications were noted. The main goal of fitting F-ScCL was to improve visual acuity in keratoconus and to improve the ocular microenvironment in LSCD. Visual acuity before and during lens wear and the average wearing time in hours per day was noted.

RESULTS

Four patients (7 eyes) with VKC wore F-ScCL for associated keratoconus (n=5 eyes), LSCD (n=2 eyes). The mean age of the patients was 17. 5 years. The LogMAR visual acuity was 0.4 and 0.18 before and during lens wear, respectively, at a mean follow-up of 14.8 months. The average lens wear was 8.30 hrs per day. Two patients developed acute hydrops at 2 and 12 months of lens wear and underwent descematopexy. Visual acuity with F-ScCL reduced by more than two lines because of the scar of healed hydrops. Of the 3 patients with keratoconus, 1 patient had used a piggy back lens system for 2.5 years before F-ScCL wear, and 2 patients had failed with rigid gas-permeable lens trial lenses.

CONCLUSIONS

With coexisting keratoconus and VKC, F-ScCL improves vision and helps to maintain the health of the ocular surface.