The medical indications for, and outcome of scleral contact lens wear
in 517 eyes of 343 patients attending a Scleral Contact Lens Clinic du
ring a 5-year period from July 1988 to June 1993 were analysed. Kerato
conus was the most common condition requiring scleral lens wear (36.2%
), followed by aphakia (18.4%), postpenetrating keratoplasty (12.0%),
irregular astigmatism secondary to corneal disease (12.0%), high myopi
a (12.8%), and ocular surface disorders (6.4%). The main indication wa
s visual (85.8%), whereas therapeutic indications accounted for 8.2% o
f cases. Seventy-six percent of cases had previously failed with other
types of contact lenses. The majority of patients were initially fitt
ed with impression moulded polymethylmethacrylate (PMMA) lenses (90.5%
); other scleral lens types included preformed PMMA lenses, preformed
high Dk gas-permeable (GP) lenses, and a GP/PMMA hybrid scleral lens d
esign. Initial scleral lens fitting was successful in 93.2% of cases,
and 71% remained successful with a mean duration of 11.8 years' follow
-up. Complications included corneal vascularisation (13.3% of eyes), e
pisodes of corneal oedema (7.4%), corneal abrasion (3.1%), and giant p
apillary conjunctivitis (1.7%). In addition to 19 eyes initially fitte
d with GP lenses, there were 99 eyes initially wearing PMMA lenses tha
t were subsequently refitted with GP scleral lenses.