The effectiveness and safety of VSL scleral lens in patients with irregular astigmatism

doi:10.3877/cma.j.issn.2095-2007.2025.03.002

Abstract

Abstract:

Objective

The aim of this study is to evaluate the efficacy and safety of VSL scleral lenses in the treatment of irregular astigmatism.

Methods

A total of 10 patients (11 eyes) with corneal irregular astigmatism who underwent VSL scleral lens fitting at Peking University Third Hospital from January to December 2024 were included. There were 5 males (5 eyes) and 5 females (6 eyes) with an mean age (22.4±13.9) years (ranging from 6 to 44 years). The VSL scleral lenses were customized by optometrists based on patients′ ocular conditions, with parameters determined by corneal topography, anterior segment optical coherence tomography (AS-OCT), and slit-lamp examination to ensure lens fitting properly. Baseline measurements were recorded after a 2-hour trial period confirmed efficacy and absence of discomfort. Follow-up visits were conducted at 1 week, 1 month, and every 3 months thereafter. The best-corrected visual acuity (BCVA) using a standard logarithmic acuity chart, intraocular pressure measurements, anterior segment photography, AS-OCT, corneal topography, patient-reported comfort, ocular symptoms, and daily artificial tear usage were evaluated. The gender, age, ocular history, lens parameters, objective metrics, and subjective feedback were collected. Visual acuity, intraocular pressure, refractive error, BCVA, and complications were analyzed using frequency and percentage distributions.

Results

The mean follow-up duration of all patients (11 eyes) was (7±2.8) months. The indications for scleral lens fitting included irregular astigmatism after corneal transplantation (4 patients, 4 eyes) and keratoconus (8 patients, 9 eyes), accounting for 36% and 82%, respectively. In keratoconus patients, the mean of K1 values was (45.5±4.8)D (ranging from 39.7 to 57.8 D); the mean of K2 was (50.6±5.9)D (ranging from 46.1 to 67.5 D; and the mean of thinnest corneal thickness was (488.3±72.6)μm (ranging from 301 to 584 μm). The mean of daily wear duration was (10.2±2.5)hours (ranging from 6 to14 hours). During follow-up, the best BCVA achieved with scleral lenses ranged from 0 to 0.3 logarithm of the minimum angle of resolution (logMAR), with a mean value of (0.06±0.11) logMAR and a mean improvement of (0.52±0.39) logMAR. After scleral lens fitting, 8 patients (9 eyes) reported significant subjective visual improvement, and 3 patients (3 eyes) showed reduced artificial tear usage, accounting for 81.8% and 27.3%, respectively. Three pediatric patients (3 eyes) exhibited enhanced visual acuity and comfort during amblyopia training with scleral lenses. The mean comfort score was (8.7±1.49) scores, with 5 patients (5 eyes) rating maximum comfort, accouting for 45.5%. No adverse events were observed.

Conclusions

The VSL scleral lenses significantly improved BCVA, alleviated ocular discomfort, and demonstrated favorable wearing comfort and high safety in patients with corneal irregular astigmatism. The VSL scleral lenses may enhance amblyopia training efficacy in children with corneal irregularities.

Key words: Scleral lens, Irregular astigmatism, Keratoconus, Clinical effects

Guoguo Tang, Rongmei Peng, Gege Xiao, Jing Hong. The effectiveness and safety of VSL scleral lens in patients with irregular astigmatism[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2025, 15(03): 135-140.

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Figures/Tables 2

References 38

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患者编号	年龄(岁)	性别	眼别	随访时间(个月)	适应证	K1(D)	K2(D)	最薄处厚度(μm)	每日配镜时长(h)	舒适度评分(分)
1	44	女	左眼	6	角膜移植术后	41.8	48.3	527	13	10
2	6	女	左眼	4	角膜移植术后，圆锥角膜	44.9	51.9	584	10～12	6
3	19	女	左眼	5	角膜移植术后	42.9	50.2	527	10～12	10
4	6	男	左眼	3	角膜移植术后，圆锥角膜	45.7	49.2	301	6	10
5	7	女	左眼	10	圆锥角膜	39.7	47.0	506	14	10
6	22	男	右眼	10	圆锥角膜	45.2	48.6	525	8	10
7	21	女	右眼	10	圆锥角膜	45.2	46.1	475	7～8	8
			左眼	10	圆锥角膜	44.3	47.2	452
8	31	男	左眼	10	圆锥角膜	49.6	51.5	456	12	8
9	24	男	左眼	7	圆锥角膜	43.0	48.9	494	9	8
10	43	男	右眼	5	圆锥角膜	57.8	67.5	524	10	7

患者编号	年龄(岁)	性别	眼别	随访时间(个月)	适应证	K1(D)	K2(D)	最薄处厚度(μm)	每日配镜时长(h)	舒适度评分(分)
1	44	女	左眼	6	角膜移植术后	41.8	48.3	527	13	10
2	6	女	左眼	4	角膜移植术后，圆锥角膜	44.9	51.9	584	10～12	6
3	19	女	左眼	5	角膜移植术后	42.9	50.2	527	10～12	10
4	6	男	左眼	3	角膜移植术后，圆锥角膜	45.7	49.2	301	6	10
5	7	女	左眼	10	圆锥角膜	39.7	47.0	506	14	10
6	22	男	右眼	10	圆锥角膜	45.2	48.6	525	8	10
7	21	女	右眼	10	圆锥角膜	45.2	46.1	475	7～8	8
			左眼	10	圆锥角膜	44.3	47.2	452
8	31	男	左眼	10	圆锥角膜	49.6	51.5	456	12	8
9	24	男	左眼	7	圆锥角膜	43.0	48.9	494	9	8
10	43	男	右眼	5	圆锥角膜	57.8	67.5	524	10	7

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