Do Scleral Lenses Suck?

Background: It is widely accepted that scleral lenses “settle” onto the eye. This is a group of investigative studies that further analyzes the structures that are responsible for this change as the lens settles, and further determines if there are any suction-like forces that are created by the loss of the tear lens that may be affecting the anterior structures. Modifications to FDA approved scleral lenses were made by having a laboratory lathe a hole into lenses in order to eliminate possible suction forces. Methods: The investigator placed optimally fit lenses to multiple eyes and took various measurements at different chord lengths. The investigator also placed an identical test lens containing a lathed fenestration and corresponding measurements were taken. All measurements were taken using anterior segment optical coherence tomography. Results: Measurements of central clearance and anterior chamber depth at various locations and time intervals were taken for the standard lens and lathed lenses. The measurements were compared for each individual eye to determine if there was a significant difference between the standard lens and the lathed lenses. Conjunctival settling only accounts for a portion of change in lens clearance. The majority of the change in vault is actually due to the cornea moving anteriorly. Conclusion: The change in central clearance for the standard and fenestrated lenses were do to an increase in anterior chamber depth over time and not solely as a result of lens “settling”. However, this does not appear to be due to lens suction forces but more likely due to a mechanical force being applied to the eye causing elongation of the eye