Role of therapeutic contact lenses in management of corneal disease

Abstract

Purpose of reviewThe current review highlights areas of innovation and research in the use of contact lenses in the treatment of corneal ectasia and ocular surface disease.Recent findingsA series of academic reports were published by a committee of experts reviewing evidence-based practice patterns of contact lens use. There continues to be active research in the use of contact lenses in the management of keratoconus, including mini-scleral lenses, custom impression-based scleral lenses and wavefront-guided scleral lenses. Recent reports on contact lenses for ocular surface disease were primarily reviews, retrospective case reports or case series, with publications on contact lens use in corneal epithelial defects, graft-vs.-host disease, limbal stem cell deficiency and neurotrophic keratitis. There are recent publications on advances in drug-eluting contact lenses.SummaryCorneal specialists should be aware of current advances in the field of contact lens expanding their use in corneal ectasia and ocular surface disease.

Patient Experiences With Therapeutic Contact Lenses and Dry Eye Disease

“…Despite well-documented benefits of both soft and SL use for management of severe dry eye disease, their use is not generally recommended as early therapy. 22,29,30 Fewer than 15% of all respondents were using contact lenses as part of their management of dry eye disease in this study. The mean age of individuals using SLs was older than those using therapeutic soft lenses.…”

“…The therapeutic benefits of SLs have been reported for patients with severe dry eye including Stevens–Johnson syndrome, graft-versus-host disease, and Sjogren syndrome. 19–22…”

Efficacy of Plasma Rich in Growth Factors (PRGF) in Stage 1 Neurotrophic Keratitis

“…OXERVATE ® (cenegermin-bkbj), an FDA-approved topical recombinant human nerve growth factor, was reported as an efficient therapy in moderate to severe NK that can lead to significant improvement in corneal sensation and complete resolution of epithelial defect ( 60 – 62 ). Bandage contact lenses (BCLs) are another therapy option for NK patients that provide corneal epithelium protection; they are widely used in some conditions like exposure keratopathy, limbal stem cell deficiency (LSCD), and severe dryness ( 60 , 63 ). Unfortunately, despite the curative effects of autologous serum and cord blood eye drops in modulating NK progress, they have toxic pro-inflammatory components that limit their usage ( 64 – 66 ).…”