Hypoxic corneal changes following eight hours of scleral contact lens wear

Abstract

Purpose. To examine the change in corneal thickness and posterior curvature following 8 hours of miniscleral contact lens wear. Methods. Scheimpflug imaging (Pentacam HR; Oculus) was captured before, and immediately following, 8 hours of miniscleral contact lens wear for 15 young (mean age 22 T 3 years), healthy participants with normal corneae. Natural diurnal variations were considered by measuring baseline corneal changes obtained on a separate control day without contact lens wear. Results. Over the central 6 mm of the cornea, a small but highly statistically significant amount of edema was observed following 8 hours of miniscleral lens wear, after accounting for normal diurnal fluctuations (mean T standard deviation percentage swelling 1.70 T 0.98%, p < 0.0001). Posterior corneal topography remained stable following lens wear (j0.01 ± 0.07 mm steepening over the central 6 mm, p = 0.60). The magnitude of posterior corneal topographical changes following lens wear did not correlate with the extent of lens-related corneal edema (r = j0.16, p = 0.57). Similarly, the initial central corneal vault (maximum post-lens tear layer depth) was not associated with corneal swelling following lens removal (r = 0.27, p = 0.33). Conclusions. Although a small amount of corneal swelling was induced following 8 hours of miniscleral lens wear (on average <2%), modern high Dk miniscleral contact lenses that vault the cornea do not induce clinically significant corneal edema or hypoxic-related posterior corneal curvature changes during short-Term wear. Longer-Term studies of compromised eyes (e.g. corneal ectasia) are still required to inform the optimum lens and fitting characteristics for safe scleral lens wear to minimize corneal hypoxia.