Clinical outcomes of scleral Misa lenses for visual rehabilitation in patients with pellucid marginal degeneration.

PURPOSE: To report the clinical outcomes of scleral Misa® lenses (Microlens Contactlens Technolgy, Arnhem, Netherlands) for visual rehabilitation in patients with pellucid marginal degeneration (PMD).

MEHODS: In this prospective interventional case series, 24 eyes of 12 PMD patients were fitted with scleral Misa® lenses. Patients were followed regularly for continuous daily wearing time (CDWT), contact lens handling issues, visual acuity, and any subjective or objective contact lens related complications.

RESULTS: The mean patient age was 35.0±13.8 years (range, 23-47 years). The average length of follow-up was 14.1±3.7 months (range, 8.5-18 months). All eyes were fit with mini Misa® scleral lenses with a diameter of 16.5 or 17mm. The mean Snellen best-corrected visual acuity (BCVA) before scleral lenses with spectacle correction was 0.42±0.15 (range, 0.2-0.6). With scleral lenses, mean BCVA was 0.75±0.15 (range, 0.5-0.9), (p=0.003) with a mean gain of 3.3 lines of BCVA. More than half (16 eyes, 67%) reported wearing their scleral lenses for 8h or more on a daily basis. Three patients (6 eyes, 25%) abandoned scleral lens wear. Patients who abandoned the scleral lens wear tended to have a better spectacle corrected visual acuity and less gain of lines.

CONCLUSIONS: Scleral lenses can be used succesfully in patients with PMD who are intolerant to other types of contact lenses. Patients who have a low spectacle BCVA and a higher gain of visual acuity with scleral lenses are good candidates for scleral lens use.