PURPOSE:

Scleral lenses (SLs) have a wide range of applications and many benefits. A custom SL (Zenlens) incorporates design flexibility and extensive customisation options and diameter options, with prolate and oblate lens geometries, to help eye care practitioners (ECPs) achieve a precise, custom fit in a wide range of patients with complex corneal conditions. However, there is limited documented real-world clinical experience with this SL in the literature. This retrospective multicentre case review documented real-world visual outcomes with this SL; here, visual outcomes and lens fitting practices are reported.

METHODS:

Ten ECPs from Canada (n=1), Ireland (n=1), and the USA (n=8) provided a deidentified retrospective convenience sample of ≥5 cases using a standardised case report form, including ≥3 complex cases with a range of customisations. ECPs were also asked to complete a satisfaction survey for all cases. Best-corrected visual acuity (BCVA), comfortable wearing time, and ocular symptoms with the SL were collected. The protocol received central institutional review board exemption.

RESULTS:

The full analysis set included 62 eyes (45 patients; 20 female; 22 male; 3 did not provide their sex). The primary diagnosis was keratoconus in 93% of patients. Mean±SD comfortable wearing time was 13±3 hours (n=62 eyes). A BCVA of 20/25 or better was achieved in 74% of cases (n=46/62 eyes). A mean±SD of 2±1 lens modifications were required to achieve a successful fit. The most frequently used diameter was 16 mm in 52% of patients, followed by 17 mm in 45% of patients. Toric or quadrant-specific peripheral curves were utilised in 77% of patients.

CONCLUSION:

This case review provided valuable insights into real-world fitting practices and visual outcomes with this customisable SL, and demonstrated its utility in patients with a variety of corneal irregularities.