This article was originally published in a sponsored newsletter.

Patients often ask how long they can keep their scleral lenses. Typically, with time, the material becomes slightly yellow, opaque, and warped. This is true regardless of manufacturer and lens type. The shelf life is much greater in button form. After the material is cut into a lens and exposed to the elements, material alternations can occur.
 
A new informative study answered the question about how often scleral lenses should be replaced.¹ A retrospective study at a tertiary care hospital examined medical records to determine the average scleral lens replacement period. All patients who had reordered a single scleral lens in one eye were included. The lens order history was examined, and statistical analyses were performed. A single practitioner fit and ordered the scleral lenses. The practitioner and patient choose the scleral lens replacement timing.
 
The study examined 445 eyes (227 OD, 218 OS) of 251 patients in total (131 women and 120 men) with an average age 57.1 ± 17.4 years, ranging from 9 to 93 years. Irregular corneas were present in 199 eyes and 246 eyes had ocular surface disease. The most prevalent conditions which made up 65.6% of eyes evaluated, were keratoconus, graft-versus-host disease, post-corneal transplant, and dry eye syndrome.
 
On average, the typical replacement period for a scleral lens was 23.9 ± 14.3 months with a range of five to 2,617 days. The average scleral lens replacement period was increased for patients who had worn scleral lenses for a longer amount of time. On average, for each additional single year of scleral lens wear, the average replacement period increased by 30.7 days.

There was no statistically significant correlation between the average scleral lens replacement period and the sex of the patient. There also was no association between the average scleral lens replacement period and the general diagnoses of irregular cornea or ocular surface disease. Additionally, there was no statistically significant correlation between prior outside scleral lens fitting lens brand or lens diameter.
 
Patients older than 80 years of age (6.4% of total patients in the study) exhibited a statistically significant decrease in the average replacement period of their scleral lenses by approximately 202.5 days when compared with patients between 51 to 70 years of age (43% of total patients in the study). A hypothesis for this association is that age reduces dexterity, hand steadiness, and grip strength.²
 
Additional studies are necessary to determine the recommended replacement period for scleral lenses and to better appreciate the clinical implications of the planned replacement for scleral lenses.

REFERENCES

1. Pritikin E, Rodman J, Chiu GB. Average Scleral Lens Replacement Period at a Tertiary Care Hospital. Eye Contact Lens. 2023 Jul 27. [Online ahead of print]

2. Martin JA, Ramsay J, Hughes C, Peters DM, Edwards MG. Age and grip strength predict hand dexterity in adults. PLoS One. 2015 Feb 17;10:e0117598.

Melissa Barnett, OD, FAAO, FSLS, is the Director of Optometry at the University of California, Davis in Davis, specializing in anterior segment disease and specialty contact lenses. She is the past president of the Scleral Lens Education Society. She is an advisor to and/or has received honoraria or travel expenses from AccuLens, Alcon, Allergan, Bausch + Lomb, Bruder, Contamac, CooperVision, Johnson & Johnson Vision, Ocusoft, ScienceBased Health, Shire, Tarsus, and Visus Therapeutics.