Nixon Alex D, Barr Joseph T, VanNasdale Dean A
The Ohio State University, 338 W 10th Avenue, Columbus, OH 43210, United States.
The Ohio State University, 338 W 10th Avenue, Columbus, OH 43210, United States.
Cont Lens Anterior Eye. 2017 Apr;40(2):116-126. doi: 10.1016/j.clae.2016.11.007. Epub 2016 Dec 16.
Complications of scleral lens wear are not well documented or understood. While multiple studies focus on oxygen transmission during scleral lens wear and associated corneal swelling, little is known about the effects of varying scleral lens fitting relationships, especially when there is corneal interaction. Scleral lenses, by convention, are designed to completely clear the corneal surface and rest on the conjunctival and scleral tissue. However, some designs maximize oxygen transmission by reducing the lens diameter, thickness, and recommended corneal clearance.While the modifications increase oxygen transmission in any scleral lens design, they also distribute the lens mass closer to the limbus and make visualization of corneal clearance, especially narrow in the limbal region, more difficult. The sequelae from mechanical interaction between scleral lenses and the ocular surface, in particular the cornea, remain uncertain. This case series will describe corneal epithelial bullae, molding, and epithelial erosions as unintended scleral lens complications. These corneal changes corresponded to areas of contact lens-corneal bearing confirmed utilizing a combined scanning laser ophthalmoscopy (SLO) and anterior segment OCT. This case series will discuss epithelial bullae detection, their etiology, and suggestions for application of this information into scleral lens fitting protocols.
巩膜镜佩戴的并发症尚未得到充分记录或了解。虽然多项研究聚焦于巩膜镜佩戴期间的氧气传输及相关的角膜水肿，但对于不同巩膜镜适配关系的影响知之甚少，尤其是存在角膜相互作用时。按照惯例，巩膜镜设计为完全覆盖角膜表面并置于结膜和巩膜组织上。然而，一些设计通过减小镜片直径、厚度和推荐的角膜间隙来最大化氧气传输。虽然这些改进在任何巩膜镜设计中都能增加氧气传输，但它们也使镜片质量更靠近角膜缘分布，使得观察角膜间隙（尤其是角膜缘区域很窄的间隙）变得更加困难。巩膜镜与眼表（特别是角膜）之间机械相互作用的后遗症仍不明确。本病例系列将描述角膜上皮大疱、塑形和上皮糜烂等意外的巩膜镜并发症。这些角膜变化与通过联合扫描激光检眼镜（SLO）和眼前节光学相干断层扫描（OCT）确认的隐形眼镜 - 角膜接触区域相对应。本病例系列将讨论上皮大疱的检测、其病因以及将此信息应用于巩膜镜适配方案的建议。
