# One-Year Impact of Scleral Lens Wear on Corneal Morphology in Keratoconus with and Without Intracorneal Ring Segment

## TL;DR

Wearing scleral lenses for a year changes corneal shape in keratoconus patients, with differences based on whether they have corneal ring segments, but vision remains stable.

## Contribution

This study reveals how long-term scleral lens use affects corneal morphology in keratoconus patients with and without intracorneal ring segments.

## Key findings

- Scleral lens wear increases superior corneal thickness and alters curvature in keratoconus patients.
- Patients with intracorneal ring segments show distinct corneal changes compared to those without.
- Visual acuity remains stable despite corneal morphological changes over one year.

## Abstract

What are the main findings?
Long-term scleral lens wear in keratoconus patients induces measurable changes in corneal morphology, including increased superior corneal thickness and region-specific alterations in anterior and posterior curvature.These structural changes differ between patients with and without intrastromal corneal ring segments (ICRS), suggesting that baseline corneal architecture influences the biomechanical response to scleral lens wear.

Long-term scleral lens wear in keratoconus patients induces measurable changes in corneal morphology, including increased superior corneal thickness and region-specific alterations in anterior and posterior curvature.

These structural changes differ between patients with and without intrastromal corneal ring segments (ICRS), suggesting that baseline corneal architecture influences the biomechanical response to scleral lens wear.

What are the implications of the main findings?
Despite corneal morphological changes, visual acuity remains stable over one year, indicating that scleral lenses provide sustained visual performance and may contribute to improving quality of life in keratoconus management.The observed changes highlight the need for the long-term monitoring of corneal parameters in scleral lens users, supporting personalized lens fitting strategies and advancing innovative approaches compared to foundational work in keratoconus care.

Despite corneal morphological changes, visual acuity remains stable over one year, indicating that scleral lenses provide sustained visual performance and may contribute to improving quality of life in keratoconus management.

The observed changes highlight the need for the long-term monitoring of corneal parameters in scleral lens users, supporting personalized lens fitting strategies and advancing innovative approaches compared to foundational work in keratoconus care.

Purpose: The purpose of this study is to evaluate changes in corneal thickness and anterior and posterior corneal curvature after one year of scleral lens wear in keratoconus eyes and to determine their impact on visual performance. Methods: Sixty-five keratoconus subjects were divided into two groups: with intrastromal corneal ring segments (KC-ICRS) and without ICRS (KC). All participants wore 16.5 mm scleral lenses for 8 h daily over 1 year. Measurements included corneal thickness, anterior and posterior curvature, and high-contrast visual acuity assessed before and after lens wear. Results: Corneal thicknesses increased significantly in the superior region of the KC-ICRS group. In curvature analysis, the KC group showed inferior steepening and superior flattening, while the KC-ICRS group exhibited central and superior-nasal anterior flattening. Posterior curvature changes included central flattening and peripheral steepening. Visual acuity remained stable across all visits and groups. Conclusions: Long-term scleral lens wear induced measurable morphological changes, including increased superior corneal thickness and region-specific curvature alterations, which varied by ICRS presence. These changes did not compromise visual acuity, supporting scleral lenses as a safe and effective option for sustained vision correction in keratoconus. The findings highlight the importance of personalized fitting and monitoring strategies in clinical practice.