Study: One-year scleral lens success rates - and why and wherefore.

Only 73% success rate among 95 patients. Why?

Hint: It’s NOT because of complications (adverse events). Nothing went horribly wrong.

The main reasons for drop-out were handling issues and discomfort.

That’s the drum I’ve been beating forever.

Optometrists, I’m telling ya, getting a successful FIT is only the beginning.

If you don’t understand our adaptation issues and needs, you will not understand your drop-out rates. Read more about what we patients need.

But there’s good news too

Participants who continued scleral lens demonstrated increased handling skills.

Keep on keeping on, it gets easier over time!

Study abstract

A one-year prospective study on scleral lens wear success. Macedo-de-Araújo RJ, van der Worp E, González-Méijome JM. Cont Lens Anterior Eye. 2019 Nov 13.

PURPOSE:

To report the success rate of scleral lens wear and the lens handling learning curve from the wearers perspective.

METHODS:

Ninety-five participants were consecutively screened for enrollment in a prospective study. Participants were divided into two groups: ICGroup (71 participants with irregular corneas) and RCGroup (24 participants with regular corneas). Participants attended several visits: Baseline, Lens Dispense Visit (LDV), 1-month, 3-month, 6-month and 12-month follow-ups. The number and causes of scleral lens discontinuation and the time to correctly apply the lens for the first time at the LDV were evaluated. During follow-ups, participants answered a questionnaire regarding scleral lens wear (mean number of hours/day and days/week of lens wear, methods used for handling, number of attempts to correctly apply and remove the lenses).

RESULTS:

Sixty-nine participants (73 %) successfully completed the 12-month period. Twenty-six participants (27 %) discontinued scleral lens wear. None of the discontinuations were due to adverse events. The success rate (number of participants that wore the lenses for the 12 months) was 77 % in ICGroup and 58 % in RCGroup. The main reasons for scleral lens discontinuation were handling issues (35 %) and discomfort (19 %). 36 % of participants required <15 min to correctly apply the lens at the LDV, however 13 % required >60 min (participants that wore spectacles, soft lenses or had no correction method at Baseline). The mean wearing time (hours/day and days/week) increased significantly from 1-month to 12-month appointments: from 9.8-11.1 h and 5.1-5.6 days in new scleral lens wearers, while the number of attempts to correctly apply and remove the lenses decreased significantly.

CONCLUSIONS:

The success rate was 73 % during this prospective 12-month follow-up study. The main reasons for drop-out were handling issues and discomfort. Participants who continued scleral lens demonstrated increased handling skills.