{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:21:18Z","timestamp":1790115678698,"version":"4.0.1"},"reference-count":37,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T00:00:00Z","timestamp":1720051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Purpose: Dry eye disease (DED) is a multifactorial condition significantly impacting patients\u2019 quality of life (QoL). This study aims to present a case series highlighting the effectiveness of customized scleral lenses in managing severe DED and improving patient outcomes. Methods: This case series includes three patients with severe DED refractory to conventional treatments. Customized scleral lenses were fitted for each patient, and clinical outcomes were evaluated over a period of two months. Assessments included best-corrected visual acuity (BCVA), slit-lamp examination findings, and corneal National Eye Institute (NEI) scores. Results: All three patients demonstrated significant improvements in BCVA, reductions in ocular symptoms, and enhanced ocular surface health. Patient 1, with secondary Sj\u00f6gren\u2019s syndrome and suspected mucous membrane pemphigoid, showed resolution of conjunctival hyperemia and epithelial defects. Patient 2, with graft versus host disease, exhibited resolution of punctate keratitis and the absence of thread mucus. Patient 3, post-oncologic surgery, achieved complete resolution of keratoconjunctivitis sicca and the restoration of vision. Conclusions: Customized scleral lenses are a useful therapeutic option for severe DED, providing significant symptomatic relief and enhancing patients\u2019 quality of life. Their use should be considered in refractory cases to optimize ocular surface health and visual outcomes.<\/jats:p>","DOI":"10.3390\/jcm13133935","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T03:48:56Z","timestamp":1720151336000},"page":"3935","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Customized Scleral Lenses: An Alternative Tool for Severe Dry Eye Disease\u2014A Case Series"],"prefix":"10.3390","volume":"13","author":[{"given":"Sebastiano","family":"Nunziata","sequence":"first","affiliation":[{"name":"Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy"},{"name":"Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Petrini","sequence":"additional","affiliation":[{"name":"Science Department, University of Rome III, 00154 Rome, Italy"},{"name":"Vision Optika, 00187 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Dell\u2019Anno","sequence":"additional","affiliation":[{"name":"Vision Optika, 00187 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Barone","sequence":"additional","affiliation":[{"name":"Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy"},{"name":"Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Coassin","sequence":"additional","affiliation":[{"name":"Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy"},{"name":"Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy"},{"name":"Rare Corneal Diseases Center, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5264-5973","authenticated-orcid":false,"given":"Antonio","family":"Di Zazzo","sequence":"additional","affiliation":[{"name":"Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy"},{"name":"Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy"},{"name":"Rare Corneal Diseases Center, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,4]]},"reference":[{"key":"ref_1","first-page":"71","article-title":"The Pathophysiology, Diagnosis, and Treatment of Dry Eye Disease","volume":"112","author":"Messmer","year":"2015","journal-title":"Dtsch. 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