Sclerals lens expectations

[dplees]

I've suffered with KC for a few years now and have undergone most KC related treatments known to man; I've had intacs (insertion, extraction and reinsertion), cxl, phakic toric iol, lipiflow and kerasoft lenses. I've also had binocular therapy with Barnard Levit.

Since being with simon levy at http://www.barnardlevit.co.uk, he has suggested I see him to try sclerals lenses, after my surgeries I have a small amount of prescription with a moderate amount of hoa's. He seems reasonably confident that sclerals will work, however I don't know if he appreciates how many 1000s of soft lenses I've tried and have still not got a good fit.
Can someone comment on sclerals lenses? Are they really that good an option, and if they are why isn't everyone wearing them? From what I've read they eliminate most hoas, are great for dry eye and are supremely comfortable- the only side affect is that they look huge

[CrippsCorner]

God I'd love to get rid of the halos... have been hearing more and more about sclerals but have never tried them myself, my hospital has never even mentioned them would love to hear more opinions too.

[sky1]

Hi,

I have worn scleral's for about 12 years. They have been brilliant for me but as with anything you do have your highs and lows with them (I can always explain more if you need me too!).

I was referred to Moorfields and Ken Pullum fitted them at the time, I believe this is the standard NHS route but there are other NHS trained fitters around the country as they are more common now than they were. There are other scleral manufacturers but I'm afraid I don't know too much about them. They are always worth a go, I had tried and failed with lots of soft lenses, a corneal graft and further relax and incision surgery. This lens especially with my grafted eye enabled me to go on to college and university, so I count my self very lucky.

Any questions please pm me if need be!

Thanks

[James_Ldn]

I've tried them, but they didn't work for me and I got better vision from my Kerasofts. But every eye is different and it's always worth a try as they may work perfectly for you.

[dplees]

Thanks for the feedback, I guess as with everything KC related - every case is individual and you can't use stats to determine the likelyhood of an outcome.
James, why were the lenses unsuccessful for you?
I've tried 100s of kerasoft lenses so sclerals are my last resort - I've been impressed with Bernard Levit this far so guess I stand some sort of a chance- I'll report back after the fitting.

[James_Ldn]

James, why were the lenses unsuccessful for you?

They seemed to fit ok, it's just that the vision was a worse than what I had with kerasoft lenses. How the lens interacts with the eye is so complicated and depends on the size of the corneal cone, it's position and it's steepness amongst other factors. I've also been told in the past that sometimes sclerals can actually make HOAs worse rather than better. So I don't think there's ever a guarantee that a particular lens will work. All we can do is try everything going and see which works best!

[DrG]

James makes a good point. Not withstanding that, rigid lenses - that includes sclerals - almost always trump soft lenses in terms of visual quality. I've seen them all and measured them all, and those instances to the contrary are relatively rare. I think the cases where they might be comparable would be in the milder or early forms of keratoconus, at a stage where crosslinking might do some good. Scleral lenses can also match soft in the comfort department as well.

[khalid4423]

I've had problems with getting rgps in my right eye and have been using scleral lens in my right eye and it has been really good and very comfortable. The problem was it took me a long time to get used to applying them in. They also seems to get dirty quickly compared to the rgps. Comfort wise they have been excellent and sometimes done even feel they are in my eye.

[CrippsCorner]

The biggest question of all though... how do you actually pronounce scleral lol?