Central and peripheral scleral lens‐induced corneal oedema

Abstract

PurposeTo quantify the magnitude of central and peripheral scleral lens‐induced corneal oedema for a range of fluid reservoir thicknesses, and to compare these experimental results with theoretical models of corneal oedema both with and without limbal metabolic support (i.e., the lateral transport of metabolites and the influence of the limbal vasculature).MethodsTen young healthy participants wore scleral lenses (KATT™, Capricornia Contact Lenses) fitted with low (mean 141 μm), medium (482 μm) and high (718 μm) central fluid reservoir thickness values across three separate study visits. The scleral lens thickness, fluid reservoir thickness and stromal corneal oedema were measured using optical coherence tomography. Oedema was quantified across the central (0–2.5 mm from the corneal apex) and peripheral (1.25–3 mm from the scleral spur) cornea. Experimental data were compared with published theoretical models of central to peripheral corneal oedema.ResultsStromal oedema varied with fluid reservoir thickness (p < 0.001) for both central and peripheral regions. The mean (standard deviation) stromal oedema was greater for the medium (2.08 (1.21)%) and high (2.22 (1.31)%) fluid reservoir thickness conditions compared to the low condition (1.00 (1.01)%) (p ≤ 0.01). Stromal oedema gradually increased from the corneal centre to the periphery by ~0.3% on average (relative increase of 18%), but the change did not reach statistical significance. This trend of increasing, rather than decreasing, oedema towards the limbus is consistent with theoretical modelling of peripheral oedema without metabolic support from the limbus.ConclusionsThe central and peripheral cornea displayed a similar magnitude of oedema, with increasing levels observed for medium and high fluid reservoir thicknesses. The gradual increase in oedema towards the limbus is consistent with a ‘without limbal metabolic support’ theoretical model.

Key Factor Influencing Corneal Edema with Scleral Lens Wear; Healthy Versus Unhealthy Corneas

“…Supporting the above-mentioned model was a recent study by Iqbal et al (2023). 10 healthy participants were fitted with ScL DK (141) and varying PoLTF thicknesses (low 141μm, medium 482μm, high 718μm) for 4 hours.…”