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.