Optical Quality and Visual Performance for One Year in a Sample of Scleral Lens Wearers

ABSTRACT SIGNIFICANCE This study shows the optical and visual quality behavior of modern scleral lenses (SLs) in the medium and long term in patients with irregular cornea (IC) and regular cornea (RC). PURPOSE The purpose of this study was to evaluate the 12-month optical quality outcomes with SL in patients with IC and RC. METHODS Sixty-nine patients completed the 12 months of follow-up (99 eyes with IC and 27 with RC). LogMAR high- and low-contrast visual acuity, whole eye aberrometry, and the size (Light Disturbance Index, %) and shape (BFCIrregSD, mm) of night vision disturbances were measured at baseline with habitual correction (HC), best spectacle correction (BSC), and SL at all the follow-up visits (1, 3, 6, and 12 months). Subjective visual quality was measured with the Quality of Vision (QoV) questionnaire. RESULTS After SL fitting, high-contrast visual acuity improved significantly compared with HC and BSC in the IC group (average improvement of +0.35 ± 0.32 and +0.29 ± 0.26 to +0.08 ± 0.14, P < .001) and RC group (+0.17 ± 0.23 and +0.12 ± 0.23 to +0.10 ± 0.23, P < .05). Light Disturbance Index decreased significantly with SL compared with HC and BSC from 13.85 ± 13.99% and 15.89 ± 13.38% to 5.75 ± 4.51% in the IC group ( P < .001) and 6.16 ± 5.38 and 5.98 ± 5.39 to 3.99 ± 3.05 in the RC group ( P < .05). BFCIrregSD also decreased significantly, namely, in the IC group (−51%). All subscales of the QoV questionnaire had a statistically significant decrease (improvement) with SL ( P < .05). CONCLUSIONS Scleral lenses promote a better subjective and objective visual quality, mainly in patients with IC. Additional measurements such as night vision disturbances, aberrometry, and subjective perceptions should be considered to characterize the visual enhancement promoted by SL in RC and IC patients.