Scleral Contact Lens Usage in Patients With Complex Blepharoptosis
- 1 March 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Ophthalmic Plastic & Reconstructive Surgery
- Vol. 27 (2), 95-98
- https://doi.org/10.1097/iop.0b013e3181d07408
Abstract
To evaluate the efficacy of scleral contact lenses (ScCLs) as an alternative or as an adjunct to surgical correction for the management of complex ptosis. A retrospective case-note review was used to determine the subjective function and cosmetic acceptability of the lenses. Digital photographs were taken, both with and without the lens in place; analytic software was used to assess the vertical height of the palpebral aperture (PA) and the upper margin-reflex distance. Three masked observers independently graded the photographs for cosmesis as "good," "moderate," or "poor." Ten patients (6 male) had been wearing ScCLs in 14 treated eyes for between 1 and 40 years (mean, 10.3 years; median, 3 years). Without a lens, the mean PA was 4.9 mm (median, 5.1 mm; range, 1.7-7.1 mm), increasing to 9.5 mm (median, 8.9 mm; range, 5.8-14.8 mm) with the lens in place (p < 0.005). Likewise, the upper margin-reflex distance increased from 0.39 mm (median, 0.03 mm; range, 0-2.4 mm) without a lens in place to 3.1 mm (median, 2.7 mm; range, 1.5-5.8 mm) with lens wear (p < 0.005). In 6 patients with unilateral ScCL wear, mean PA was 10.4 mm in the treated eye and 8.4 mm in the eye without a lens (p = 0.22). All patients who were wearing ScCLs long term found them to be both comfortable and cosmetically acceptable. On subjective grading of photographs, however, the cosmesis was judged as "good" in 22%, "moderate" in 64%, and "poor" in 14%. In some patients, ScCLs provide a well-tolerated and practical long-term solution to safely elevating the upper eyelid in which complex ptosis is present. The patients in our cohort seem to be satisfied with the cosmesis, although there are some limitations to this aspect when viewed subjectively.Keywords
This publication has 11 references indexed in Scilit:
- Frontalis sling operation using silicone rod for the correction of ptosis in chronic progressive external ophthalmoplegiaBritish Journal of Ophthalmology, 2008
- Surgical Management of Complete Blepharoptosis with No Levator Function from a Compressive Third Nerve PalsyOphthalmic Surgery, Lasers and Imaging Retina, 2008
- Therapeutic and Ocular Surface Indications for Scleral Contact LensesThe Ocular Surface, 2007
- Advantages of Toric Scleral LensesOptometry and Vision Science, 2006
- Scleral Contact LensesCornea, 2005
- The Boston Scleral Lens in the management of severe ocular surface diseaseOphthalmology Clinics of North America, 2003
- Gas-permeable scleral contact lens therapy in ocular surface diseaseAmerican Journal of Ophthalmology, 2000
- Hypoxic corneal changes following sealed gas permeable impression scleral lens wearJournal of The British Contact Lens Association, 1990
- A Gas-Permeable Scleral Contact Lens for Visual RehabilitationAmerican Journal of Ophthalmology, 1990
- Gas permeable haptic lensesJournal of The British Contact Lens Association, 1983