Purpose

To describe international scleral lens prescription and management practices across multiple practice types.

Methods

For this cross-sectional study, scleral lens practitioners were asked to complete an electronic survey that requested information about a single scleral lens patient. Data collected included practitioner demographics (practice type, country, years of experience) and patient indications for scleral lens wear, fitting process, lens design, and care products.

Results

Data were collected for 259 patients (419 eyes). Most participants (60%) practiced in the US, 75% worked primarily in community practice, and 58% claimed more than 5 years’ experience fitting scleral lenses. Indications for scleral lens wear were corneal irregularity (87%), ocular surface disease (9%), and uncomplicated refractive error (4%). During the fitting process, the mean (SD) number of lenses ordered was 2.4 (1.6) (range, 1–16 lenses) during 3.8 (2.4) visits (range, 1–18 visits). Of patients, 62% used a daily surfactant cleaner, 47% used hydrogen peroxide disinfection, and 67% used single-use vials of nonpreserved saline. Mean lens diameter was 16.2 (1.1) mm (range, 11.8–23.0 mm). The landing zones were spherical (64%), toric (26%), quadrant-specific (7%), and custom (3%) designs. Optical power was spherical in 70%, toric in 27%, and higher-order aberration correcting in 3% of lenses. Only 5 lenses had multifocal optics.

Conclusions

General consensus regarding prescribing patterns (lens design, wearing schedules, care products) between US vs non-US, community vs academic, and new vs established providers is reported in this study. Relatively low percentages of patients wearing lenses with advanced landing zones or optical designs suggest that these new options have not been widely adopted.

中文翻译：

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巩膜镜处方和管理实践：新兴共识

 目的

描述跨多种实践类型的国际巩膜镜处方和管理实践。

 方法

在这项横断面研究中，巩膜镜从业者被要求完成一项电子调查，要求提供有关单个巩膜镜患者的信息。收集的数据包括从业者人口统计数据（执业类型、国家/地区、经验年限）以及巩膜镜佩戴、验配过程、镜片设计和护理产品的患者适应症。

 结果

收集了 259 名患者（419 只眼睛）的数据。大多数参与者 (60%) 在美国执业，75​​% 主要在社区执业，58% 声称拥有 5 年以上验配巩膜镜的经验。巩膜镜佩戴的适应症是角膜不规则（87%）、眼表疾病（9%）和单纯性屈光不正（4%）。在验配过程中，在 3.8 (2.4) 次就诊（范围为 1-18 次就诊）期间，订购镜片的平均 (SD) 数量为 2.4 (1.6)（范围为 1-16 枚镜片）。在患者中，62% 的患者每天使用表面活性剂清洁剂，47% 的患者使用过氧化氢消毒，67% 的患者使用一次性小瓶非防腐盐水。平均镜片直径为 16.2 (1.1) 毫米（范围：11.8–23.0 毫米）。着陆区有球形（64%）、复曲面（26%）、特定象限（7%）和定制（3%）设计。 70% 的镜片采用球面光焦度，27% 采用复曲面镜片，3% 的镜片采用高阶像差校正。只有 5 个镜片具有多焦点光学器件。

 结论

本研究报告了美国与非美国、社区与学术界、新的与成熟的医疗服务提供者之间关于处方模式（镜片设计、佩戴时间表、护理产品）的普遍共识。佩戴具有先进着陆区或光学设计的镜片的患者比例相对较低，这表明这些新选择尚未得到广泛采用。