Modern clinical use of Mini- scleral contact lenses WCO VI – Boston 2010. Dr Langis Michaud OD M.SC. FAAO (Dipl) Associate Professor.

Modern clinical use of Mini-scleral contact lenses WCO VI – Boston 2010.

Dr Langis Michaud OD M.SC. FAAO (Dipl)

Associate Professor

Disclosure The author of this poster have received

research funding from Laboratoires Blanchard (Sherbrooke, Québec)

There is no other financial interest in the subject matter of this poster.

Classification ( Dr Sindt, o.d.) Corneo-scleral contact lenses : 12.0 -13.5 mm

Semi-scleral lenses : 13.6 –14.9 mm

Mini-scleral: 15.0 – 18.0 mm

Scleral lenses 18.1- 24.0 mm

Mini-scleral lens modern usage Graft vs Host disease (GVH) Atopic keratoconjunctivitis Corneal disorders /surface diseases / dystrophies Corneal ectasia (KC/PMD) Post-graft Post-refractive surgery Intolerance to other modalities High refractive errors (myopia, astigmatism)

Mini-scleral applications

Patient with corneal dystrophy (Groenouw I) OD and a corneal graft OS

Clinical advantages of Mini-scleral lenses To improve visual acuity

To increase lenses comfort and stability

To favor oxygen transmissibility

To help to restore ocular health Valuable option for chronic ocular surface diseases

Reasons for failure Handling too difficult (40%)

Age, dexterity Discomfort (25%)

Becomes a symptom of a bad fit…. Seal off of the conjunctiva or the limbal area

No better visual outcome (15%) Vision problem not related to corneal surface

Cost (12%) Other systemic causes – toxicity to solutions,

intolerance, etc (8%)

Photo gallery

Corneal scarring secondary to a chronic inflammation of the cornea

Uncorrected V.A. 6/40BCVA with Mini-scleral c.l. 6/7,5

Fitted with a MSD 15,8 lens / DD profile

The best alternative Acculens – Maxim 4 and 5 (Denver, Colorado)

The easiest mini-scleral lens to fit nowadays (diam from16 to 17,5 mm)

Comfortable – predictable

Extended range of parameters available

Conclusion Mini-scleral lenses are part of modern

treatment of corneal ectasia, post-surgery corneal restoration and chronic ocular surface disorders.

Other applications include refractive errors or intolerance with other type of contact lenses

Relatively easy to fit with modern designs Learning curve exists however

The last word To fit Mini-Scleral lenses is a rewarding

process

Better results are achieved over time

Mini-scleral lenses should not be considered the last option any more….

More info: www.sclerallens.org

Author biography OD- U de Montréal (1986) M.SC. – U de Montréal (1998) 3rd cycle- short program ENAP

Montréal - Public health (2006)

Associate Professor (2001-…)École d’optométrie de l’Université de Montréal

Head- contact lens department- clinical studies in contact lenses

Fellow American Academy of Optometry (1998)

Diplomate- Cornea and Contact lenses (1995)

Publications

list available upon request

poster and lectures at ARVO, AAO and AOA, nationally and internationally

Research interests

Cornea, anterior segment

Specialty contact lenses

Fabry’s disease and MPS

Contact

[email protected]

514.343.6111 ext 8945