The 2018 Global Specialty Lens Symposium (GSLS) in January presented nearly 120 posters, which was a symposium record. Among the posters, 89 pertained to some form of GP lenses; of those, 67 (or 57% of the total posters) pertained to scleral lenses. Several of the most interesting posters are highlighted here.

SCOPEing Our Scleral Lens Trends

Three posters pertained directly or indirectly to the results of the Scleral Lenses in Current Ophthalmic Practice Evaluation (SCOPE) study. In “Scleral lens fitting strategies of practitioners with various levels of experience,” (Fogt et al), the authors found that practitioners who had 10 years or less of experience were more likely to use anterior segment optical coherence tomography (AS-OCT) to aid in fitting, and fitters who had five years or less of experience were more likely to use AS-OCT to evaluate conjunctival alignment of a scleral lens.

In “Scleral Lens Experience in Patients with Keratoconus (SCOPE Study)” (Nau et al), the authors found that in 750 eyes of keratoconus patients, 25.1% wore corneal GP lenses, 24.7% scleral lenses, 20% glasses, 10.4% no correction, 7.9% hybrids, and 5.1% soft lenses. For those keratoconus individuals wearing bilateral scleral lenses, 85.5% were satisfied or very satisfied with their vision, 81.6% were satisfied or very satisfied with comfort, and 63.2% were satisfied or very satisfied with ease of use.

In “Patient Experience with Scleral Lenses: Wearing Schedule and Care Regimen” (Schornack et al), the authors found that almost 50% of scleral lens patients in the survey used hydrogen peroxide for disinfection, and almost 62% used a daily surfactant cleaner. They also found that between 25% to 30% of the surveyed wearers report mid-day fogging, and a similar number reported routinely removing and reapplying their lenses during the day.

Also pertaining to scleral lenses was the poster “Practitioner Learning Curve in Fitting Mini-scleral Contact Lenses in Irregular and Regular Corneas using a Fitting Trial” (Macedo-de-Araujo et al). The authors reported on 156 consecutive scleral lens fittings on irregular (N = 122) and regular (N = 34) corneas. The average number of trial lenses to achieve a good fit did not differ between groups (1.85 for irregular corneas; 1.88 for regular corneas). The number of reorders was similar as well (N = 0.73 for irregular corneas; N = 0.88 for regular corneas), but this value was reduced to 0.25 per eye for the last 16 scleral patients. There was also a trend to use more toric landing zone designs over time (from 35% in the initial fittings to > 90% after 40 fits).

New Developments in Overnight Orthokeratology

Ramdass and Norman presented the poster “Effect of Orthokeratology in Patients with ≥ –4.00D of Myopia.” Viewing 37 patient records with baseline myopia between –4.00D to –6.00D, they found that by the end of one month of wear, patients can expect to achieve more than 80% of targeted correction, with more than 90% of expected correction achieved after three months of lens wear in this cohort.

Kojima et al presented the poster “Orthokeratology Treatment Zone Size and its Relationship to High Order Aberrations.” They found that as treatment zone diameter decreases, peripheral plus power within the central 5.0mm chord increases. Also, the smaller the treatment zone, the higher the change in positive spherical aberration. They concluded that, if their hypothesis is correct that higher positive spherical aberration is beneficial in myopia control, then, theoretically, smaller treatment zones may provide greater myopia-controlling effects.

Improved Quality of Life

Many posters presented case studies in which scleral lenses improved wearers’ quality of life. The cases covered ocular surface disease (including Stevens-Johnson syndrome), graft-versus-host disease, limbal stem cell deficiency, vertical diplopia, corneal scarring in children, and epithelial defect as well as ability to avoid a corneal transplant. Almost all of the posters are available in pdf format at www.gslsymposium.com/posters2018 . CLS