Role of rigid gas-permeable scleral contact lenses in the management of advanced atopic Keratoconjunctivitis

Purpose: To describe the use of rigid gas-permeable scleral contact lenses (ScCL) in the treatment and visual rehabilitation of patients with medically controlled advanced atopic keratoconjunctivitis (AKC). Methods: Retrospective chart review of 10 eyes with medically controlled advanced AKC whose treatment included the use of ScCL for protection of the cornea from the ocular surface environment and visual rehabilitation. Outcomes measured were changes in biomicroscopic findings and visual acuity. Results: Median follow-up period after ScCL fitting was 20.5 months (range, 14-32 months). An improvement in conjunctival hyperemia and corneal epithelial defects was observed in all eyes. Median best-corrected visual acuity before ScCL was logMAR 0.651 (Snellen 20/90; range, 20/45-20/400). After proper ScCL fitting, median logMAR visual acuity was 0.239 (Suellen 20/35; range, 20/20-20/50; P = 0.001). All patients gained at least I line of vision after initiation of ScCL, and 9 of 10 eyes experienced an improvement of at least 2 lines of vision. ScCL use was well tolerated by all patients, and no complications or infections occurred as a result of ScCL wear. Conclusions: Rigid gas-permeable ScCL are useful and safe to use in the management of the ocular surface and in the visual rehabilitation of eyes with medically controlled advanced AKC.