Estudio de los cambios en la superficie ocular por el uso de lentes de contacto esclerales

Abstract

Scleral contact lenses (LCE) have a wide range of therapeutic and optical applications. They are gas-permeable contact lenses that have their only support on the sclera, covering the cornea with a lacrimal film meniscus, thus remaining stable in a centered position and they could be a non-surgical option for visual compensation in irregular corneas, such as keratoconus or post-refractive surgery ectasia. Previous short-term studies have shown visual and subjective comfort improvement in LCE users in both normal corneas and irregular corneas. In addition, it has been described that they can produce changes in corneal curvature despite not leaning on the cornea. However, the topographic changes that may occur in the long term are unknown. On the other hand, the tear film meniscus between the lens and the cornea could change the wettability and stability of the ocular surface, due to the few tear film exchange. However, the use of LCE would decrease the dry eye symptoms and increase the tolerance of users in terms of wearing duration. The main LCE complications are the reduction of oxygenation to the cornea and the edge indentation of the lenses on the conjunctiva. Currently, there are different published short-term studies that corroborate the safety and efficacy of the LCE, together with studies showing some of the changes that occur at the ocular surface level. However, no studies are available about the possible changes in the morphological and physiological level, which can be detected on the conjunctival surface cells and the corneal subbasal nerve plexus. The main objectives of this study were the following: to evaluate corneal topographic changes of the anterior and posterior surface, to know the changes that could be developed on the tear film, to analyze the morphological changes that yield at the conjunctival cellular level on Goblet cells and to assess the morphological changes produced on the subbasal corneal plexus after the LCE use in patients with irregular cornea...