Impact of Scleral Lens Wear on Intraocular Pressure, Retinal Structure, and Choroidal Vascularity

Objectives: To evaluate the effects of scleral lens (SL) wear on intraocular pressure (IOP), retinal parameters, and choroidal metrics in habitual SL wearers with keratoconus. Methods: This cross-sectional study included 25 eyes of 25 habitual SL wearers with keratoconus and 25 eyes of 25 healthy controls. Measurements were obtained before SL wear and immediately after lens removal after 4 hr of wear. IOP, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) were evaluated. Results: Mean SL wear duration was 3.9±3.8 years. Mean IOP was 12.16±3.00 mm Hg before wear and 12.14±2.90 mm Hg after 4 hr, with a paired mean difference of 0.01 mm Hg (95% CI, −0.76 to 0.78; P =0.678). No statistically significant changes were observed in RNFL, GCC, SFCT, or CVI after 4 hr ( P =0.929, 0.094, 0.098, and 0.424, respectively). CVI did not differ between groups before or after SL wear ( P =0.114 and 0.358, respectively). Conclusions: Four hours of SL wear was not associated with statistically significant changes in IOP, RNFL, GCC, SFCT, or CVI in habitual SL wearers with keratoconus.