Efficacy of gas permeable scleral lenses in refractory severe dry eye syndrome

Abstract

AbstractPurpose Modern scleral lenses have shown their efficacy in severe ocular surface diseases such as Stevens‐Johnson syndrome. Their geometry allows hydration and protection of the cornea and of the limbus. This study determined the efficacy of modern scleral contact lenses in severe eye dry syndrome.Methods A retrospective single‐center study was conducted in patients with severe refractory dry eye syndrome, who were fitted with SPOT® scleral lenses (LAO, Thonon, France). At inclusion and after 3 months of daily wear, the following parameters were assessed: Ocular Surface Disease Index (OSDI) score, NEI Visual Function Questionnaire‐25 composite score (NEI VFQ‐25), best‐corrected visual acuity, slit lamp examination, number of associated drugs and tolerability.Results The files of 10 patients (9 women and 1 man) with a mean age of 58.4 years (40‐80 years), were reviewed. Dry eye was related to Sjögren syndrome (6 patients), ocular cicatricial pemphigoid (3 patients) and graft versus host disease (1 patient). Lens fitting failed in 1 case. Improvement of quality of life scores (OSDI and NEI NFQ‐25) was remarkable in seven patients out of the nine fitted patients. Mean OSDI and NEI VFQ‐25 scores improved from 73.5±16.8 to 35±24.2 (p=0.002) and from 49.0±21.0 to 70.5±18.4 (p=0.045), respectively. Best corrected visual acuity improved by 3.2±4.3 Snellen lines. Mean follow‐up was 12.6±3.8 months. No serious adverse events attributable to the scleral lenses occurred.Conclusion Scleral lenses are a promising therapeutic in patients with severe refractory dry eye syndrome. The results can be spectacular with a dramatic improvement of patients’ quality of life. Difficulties in manipulation represent the main disadvantage.