Image- and Impression-Based Technology in Scleral Lens Fitting for Keratoconus: Availability and Utilization

Abstract

Objective: Scleral lenses (SLs) can be customized using traditional diagnostic lens fitting or by using image- and/or impression-based technologies. This study describes the availability and usage of SL fitting technology in patients with keratoconus. Methods: An online survey queried practitioners on the mode of practice, country of residence, and estimated number of SL fits completed for keratoconus. Practitioners were asked whether they had access to image- and/or impression-based technology and to estimate the percentage of fits completed using diagnostic fitting, image-based technology, and impression-based technology. Access and usage of technology was compared between academic and community practices, United States and non–United States, and high-volume (≥60 SLs) and low-volume fitters. Results: 423 practitioners who fit SL for keratoconus participated. Image- and impression-based technologies were more frequently available in academic practices compared with community practices and high-volume compared with low-volume practitioners (P<0.005). Practitioners with image-based technology used it for a median [interquartile range] 5 [25]% of SL fittings; those with impression-based technology used it for 8 [9]% of fittings, and those with both types of technology used image-based devices for 12 [23]% of fittings and impression-based for 5 [8]% of fittings. Conclusions: In this study, most participants report using diagnostic lenses to fit SLs for patients with keratoconus.