{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:40:11Z","timestamp":1793493611691,"version":"4.5.0"},"reference-count":100,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Corneal ectasias, including keratoconus (KC), pellucid marginal degeneration (PMD), and post-LASIK ectasia, poses significant visual rehabilitation challenges due to the resultant irregular astigmatism, myopia, and higher-order aberrations (HOAs). These conditions often resist traditional corrective methods, necessitating advanced optical solutions. Scleral lenses (SLs) have emerged as a primary non-surgical option for managing these complex corneal irregularities. SLs form a smooth optical interface by forming a tear-filled chamber between the lens and the cornea, effectively mitigating HOAs and improving both high-contrast and low-contrast visual acuity (VA). This review evaluates the efficacy of SLs in enhancing VA and reducing aberrations in patients with corneal ectasia. It also explores the technological advancements in SLs, such as profilometry and wavefront-guided systems, which enable more precise and customized lens fittings by accurately mapping the eye\u2019s surface and addressing specific visual aberrations. The current body of evidence demonstrates that custom SLs significantly improve visual outcomes across various ectatic conditions, offering superior performance compared to conventional correction methods. However, challenges such as the complexity of fitting and the need for precise alignment remain. Ongoing innovations in SL technology and customization are likely to further enhance their clinical utility, solidifying their role as an indispensable tool in the management of corneal ectasias.<\/jats:p>","DOI":"10.3390\/jpm14101051","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T03:53:47Z","timestamp":1728618827000},"page":"1051","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of Scleral Lenses on Visual Acuity and Ocular Aberrations in Corneal Ectasia: A Comprehensive Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Vincenzo","family":"Barone","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":"Department of Sciences, Optometry and Optics, Roma Tre University, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano","family":"Nunziata","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7721-4694","authenticated-orcid":false,"given":"Pier Luigi","family":"Surico","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":"Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Scarani","sequence":"additional","affiliation":[{"name":"Department of Sciences, Optometry and Optics, Roma Tre University, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Offi","sequence":"additional","affiliation":[{"name":"Department of Sciences, Optometry and Optics, Roma Tre University, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Villani","sequence":"additional","affiliation":[{"name":"Department of Sciences, Optometry and Optics, Roma Tre University, 00144 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"}],"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":[[2024,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.jcrs.2014.04.013","article-title":"Biomechanics of Corneal Ectasia and Biomechanical Treatments","volume":"40","author":"Roberts","year":"2014","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.preteyeres.2018.05.002","article-title":"Pathogenesis of Keratoconus: The Intriguing Therapeutic Potential of Prolactin-Inducible Protein","volume":"67","author":"Sharif","year":"2018","journal-title":"Prog. Retin Eye Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/ICO.0000000000000408","article-title":"Global Consensus on Keratoconus and Ectatic Diseases","volume":"34","author":"Gomes","year":"2015","journal-title":"Cornea"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1136\/bjophthalmol-2020-316481","article-title":"Progression of Keratoconus in Children and Adolescents","volume":"107","author":"Meyer","year":"2023","journal-title":"Br. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.clae.2010.04.006","article-title":"Keratoconus: A Review","volume":"33","author":"Wolffsohn","year":"2010","journal-title":"Cont. Lens. Anterior Eye"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ajo.2016.12.015","article-title":"Age-Specific Incidence and Prevalence of Keratoconus: A Nationwide Registration Study","volume":"175","author":"Godefrooij","year":"2017","journal-title":"Am. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101559","DOI":"10.1016\/j.clae.2021.101559","article-title":"Keratoconus: An Updated Review","volume":"45","author":"Carracedo","year":"2022","journal-title":"Cont. Lens. Anterior Eye"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1002\/1096-8628(20000828)93:5<403::AID-AJMG11>3.0.CO;2-A","article-title":"Genetic Epidemiological Study of Keratoconus: Evidence for Major Gene Determination","volume":"93","author":"Wang","year":"2000","journal-title":"Am. J. Med. Genet."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1111\/ceo.13852","article-title":"Topographic Screening Reveals Keratoconus to Be Extremely Common in Down Syndrome","volume":"48","author":"Mathan","year":"2020","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"38","DOI":"10.3928\/0191-3913-19940101-08","article-title":"Leber Congenital Amaurosis and Its Association with Keratoconus and Keratoglobus","volume":"31","author":"Elder","year":"1994","journal-title":"J. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Yam, G.H.F., Fuest, M., Zhou, L., Liu, Y.C., Deng, L., Chan, A.S.Y., Ong, H.S., Khor, W.B., Ang, M., and Mehta, J.S. (2019). Differential Epithelial and Stromal Protein Profiles in Cone and Non-Cone Regions of Keratoconus Corneas. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-39182-6"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e777","DOI":"10.1111\/aos.14714","article-title":"Oxidative and Antioxidative Stress Markers in Keratoconus: A Systematic Review and Meta-Analysis","volume":"99","author":"Navel","year":"2021","journal-title":"Acta Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Alkanaan, A., Barsotti, R., Kirat, O., Khan, A., Almubrad, T., and Akhtar, S. (2019). Collagen Fibrils and Proteoglycans of Peripheral and Central Stroma of the Keratoconus Cornea\u2014Ultrastructure and 3D Transmission Electron Tomography. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-56529-1"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.4103\/ijo.IJO_1191_19","article-title":"Relevance of IgE, Allergy and Eye Rubbing in the Pathogenesis and Management of Keratoconus","volume":"68","author":"Ahuja","year":"2020","journal-title":"Indian J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/cxo.12579","article-title":"Clinical Biomicroscopy and Retinoscopy Findings of Keratoconus in a Middle Eastern Population","volume":"101","author":"Naderan","year":"2018","journal-title":"Clin. Exp. Optom."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1016\/j.jcrs.2017.07.021","article-title":"New Perspectives on the Detection and Progression of Keratoconus","volume":"43","year":"2017","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kanclerz, P., Khoramnia, R., and Wang, X. (2021). Current Developments in Corneal Topography and Tomography. Diagnostics, 11.","DOI":"10.3390\/diagnostics11081466"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.clae.2018.11.010","article-title":"Pellucid Marginal Degeneration: Detection, Discrimination from Other Corneal Ectatic Disorders and Progression","volume":"42","year":"2019","journal-title":"Cont. Lens. Anterior Eye"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"474","DOI":"10.3928\/1081597X-20140429-02","article-title":"Current Options in the Management of Pellucid Marginal Degeneration","volume":"30","author":"Moshirfar","year":"2014","journal-title":"J. Refract. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/S0021-5155(03)00126-6","article-title":"Progression of Pellucid Marginal Degeneration and Higher-Order Wavefront Aberration of the Cornea","volume":"47","author":"Kamiya","year":"2003","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.clae.2010.11.007","article-title":"Pellucid Corneal Marginal Degeneration: A Review","volume":"34","author":"Jinabhai","year":"2011","journal-title":"Cont. Lens. Anterior Eye"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/0039-6257(84)90094-8","article-title":"Keratoconus and Related Noninflammatory Corneal Thinning Disorders","volume":"28","author":"Krachmer","year":"1984","journal-title":"Surv. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1016\/S0886-3350(02)02038-2","article-title":"Intracorneal Rings for the Correction of Pellucid Marginal Degeneration","volume":"29","author":"Galal","year":"2003","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4055","DOI":"10.1113\/jphysiol.2008.157669","article-title":"Interdependent Roles for Hypoxia Inducible Factor and Nuclear Factor-KappaB in Hypoxic Inflammation","volume":"586","author":"Taylor","year":"2008","journal-title":"J. Physiol."},{"key":"ref_25","unstructured":"Sahu, J., and Raizada, K. (2024). Pellucid Marginal Corneal Degeneration, StatPearls."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0014-4835(81)80051-6","article-title":"Pellucid Marginal Corneal Degeneration: A Clinicopathologic Study of Two Cases","volume":"33","author":"Rodrigues","year":"1981","journal-title":"Exp. Eye Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1080\/08820538.2019.1569075","article-title":"Post-LASIK Ectasia: Twenty Years of a Conundrum","volume":"34","year":"2019","journal-title":"Semin. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/aos.15636","article-title":"Comprehensive Management of Post-LASIK Ectasia: From Prevention to Treatment","volume":"101","author":"Zhao","year":"2023","journal-title":"Acta Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ophtha.2007.03.073","article-title":"Risk Assessment for Ectasia after Corneal Refractive Surgery","volume":"115","author":"Randleman","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"P170","DOI":"10.1016\/j.ophtha.2018.10.023","article-title":"Corneal Ectasia Preferred Practice Pattern\u00ae","volume":"126","author":"Akpek","year":"2019","journal-title":"Ophthalmology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1097\/OPX.0000000000000922","article-title":"Topographic, Tomographic, and Aberrometric Characteristics of Post-LASIK Ectasia","volume":"93","author":"Padmanabhan","year":"2016","journal-title":"Optom. Vis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1080\/08820538.2018.1539183","article-title":"Incidence and Clinical Characteristics of Post LASIK Ectasia: A Review of over 30,000 LASIK Cases","volume":"33","author":"Bohac","year":"2018","journal-title":"Semin. Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1016\/j.jcrs.2003.08.006","article-title":"Bilateral Keratectasia after Unilateral Laser in Situ Keratomileusis: A Retrospective Diagnosis of Ectatic Corneal Disorder","volume":"29","author":"Wang","year":"2003","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1097\/ICO.0000000000000504","article-title":"Contemporary Treatment Paradigms in Keratoconus","volume":"34","author":"McGhee","year":"2015","journal-title":"Cornea"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Shneor, E., Pi\u00f1ero, D.P., and Doron, R. (2021). Contrast Sensitivity and Higher-Order Aberrations in Keratoconus Subjects. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-92396-5"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1007\/s10792-017-0620-5","article-title":"Ocular, Corneal, and Internal Aberrations in Eyes with Keratoconus, Forme Fruste Keratoconus, and Healthy Eyes","volume":"38","author":"Naderan","year":"2018","journal-title":"Int. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1097\/OPX.0000000000000253","article-title":"Contrast Sensitivity Function after Correcting Residual Wavefront Aberrations during RGP Lens Wear","volume":"91","author":"Yang","year":"2014","journal-title":"Optom. Vis. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.jcrs.2009.09.026","article-title":"Wave Aberration of Human Eyes and New Descriptors of Image Optical Quality and Visual Performance","volume":"36","author":"Lombardo","year":"2010","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"397","DOI":"10.3928\/1081-597X-19980701-05","article-title":"Corneal Aberrations and Visual Performance after Radial Keratotomy","volume":"14","author":"Applegate","year":"1998","journal-title":"J. Refract. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"507","DOI":"10.3928\/1081-597X-20000901-04","article-title":"Corneal First Surface Optical Aberrations and Visual Performance","volume":"16","author":"Applegate","year":"2000","journal-title":"J. Refract. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1097\/OPX.0000000000000377","article-title":"Clinical Applications of Wavefront Refraction","volume":"91","author":"Bruce","year":"2014","journal-title":"Optom. Vis. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"73","DOI":"10.5455\/msm.2023.35.73-78","article-title":"Management of Post-LASIK Ectasia","volume":"35","author":"Bohac","year":"2023","journal-title":"Mater. Sociomed."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s40123-017-0099-1","article-title":"Keratoconus Treatment Algorithm","volume":"6","author":"Andreanos","year":"2017","journal-title":"Ophthalmol. Ther."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.ophtha.2003.09.035","article-title":"Pellucid Marginal Corneal Degeneration","volume":"111","author":"Sridhar","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.clae.2015.11.005","article-title":"Scleral Contact Lenses in the Management of Pellucid Marginal Degeneration","volume":"39","author":"Rathi","year":"2016","journal-title":"Cont. Lens. Anterior Eye"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/opo.12802","article-title":"The Effect of Scleral Lenses on Vision, Refraction and Aberrations in Post-LASIK Ectasia, Keratoconus and Pellucid Marginal Degeneration","volume":"41","author":"Kumar","year":"2021","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/00006324-200302000-00007","article-title":"On-Eye Measurement of Optical Performance of Rigid Gas Permeable Contact Lenses Based on Ocular and Corneal Aberrometry","volume":"80","author":"Dorronsoro","year":"2003","journal-title":"Optom. Vis. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.2147\/OPTH.S52483","article-title":"Scleral Lens for Keratoconus: Technology Update","volume":"9","author":"Rathi","year":"2015","journal-title":"Clin. Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.jfo.2020.08.016","article-title":"Scleral Contact Lenses: Visual Outcomes and Tolerance. A Prospective Study about 98 Eyes","volume":"44","author":"Bennis","year":"2021","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.jfo.2014.10.018","article-title":"Quality of Life in Patients Wearing Scleral Lenses","volume":"38","author":"Picot","year":"2015","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jfo.2017.09.011","article-title":"Evaluation of the Quality of Life of Patients Fitted with Scleral Lenses Using a Moroccan Version of NEI-VFQ 25","volume":"41","author":"Baali","year":"2018","journal-title":"J. Fr. Ophtalmol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/ICL.0000000000000821","article-title":"Quality-of-Life Improvement after Scleral Lens Fitting in Patients with Keratoconus","volume":"47","author":"Baudin","year":"2021","journal-title":"Eye Contact Lens"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"475","DOI":"10.5935\/0004-2749.20180089","article-title":"Visual Performance of Scleral Lenses and Their Impact on Quality of Life in Patients with Irregular Corneas","volume":"81","author":"Ozek","year":"2018","journal-title":"Arq. Bras. Oftalmol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.clae.2019.09.006","article-title":"The Official Guide to Scleral Lens Terminology","volume":"43","author":"Michaud","year":"2020","journal-title":"Cont. Lens. Anterior Eye"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2147\/OPTO.S257081","article-title":"Historical Development, Applications and Advances in Materials Used in Spectacle Lenses and Contact Lenses","volume":"12","author":"Pillay","year":"2020","journal-title":"Clin. Optom."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.clae.2018.04.201","article-title":"Scleral Lenses: History & Future","volume":"41","author":"Barnett","year":"2018","journal-title":"Cont. Lens. Anterior Eye"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.clae.2021.02.001","article-title":"CLEAR\u2014Scleral Lenses","volume":"44","author":"Barnett","year":"2021","journal-title":"Cont. Lens. Anterior Eye"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Nunziata, S., Petrini, D., Dell\u2019Anno, S., Barone, V., Coassin, M., and Di Zazzo, A. (2024). Customized Scleral Lenses: An Alternative Tool for Severe Dry Eye Disease\u2014A Case Series. J. Clin. Med., 13.","DOI":"10.3390\/jcm13133935"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/ICU.0000000000000171","article-title":"Scleral Lens Use in Dry Eye Syndrome","volume":"26","author":"Bavinger","year":"2015","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1097\/ICL.0000000000000957","article-title":"Current Trends in Scleral Lens Prescription, Management, and Evaluation","volume":"49","author":"Schornack","year":"2023","journal-title":"Eye Contact Lens"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"165","DOI":"10.51329\/mehdiophthal1435","article-title":"Update on Indications, Complications, and Outcomes of Scleral Contact Lenses","volume":"10","year":"2022","journal-title":"Med. Hypothesis Discov. Innov. Ophthalmol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1097\/ICL.0000000000000922","article-title":"Ocular Impression-Based Scleral Lens with Wavefront-Guided Optics for Visual Improvement in Keratoconus","volume":"48","author":"Gelles","year":"2022","journal-title":"Eye Contact Lens"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1097\/OPX.0000000000000275","article-title":"Wavefront-Guided Scleral Lens Correction in Keratoconus","volume":"91","author":"Marsack","year":"2014","journal-title":"Optom. Vis. Sci."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/OPX.0b013e318288d19c","article-title":"Wavefront-Guided Scleral Lens Prosthetic Device for Keratoconus","volume":"90","author":"Sabesan","year":"2013","journal-title":"Optom. Vis. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/OPX.0000000000001365","article-title":"Comparison of Wavefront-Guided and Best Conventional Scleral Lenses after Habituation in Eyes with Corneal Ectasia","volume":"96","author":"Hastings","year":"2019","journal-title":"Optom. Vis. Sci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1097\/OPX.0000000000001563","article-title":"Case Report: What Are We Doing for Our \u201c20\/20 Unhappy\u201d Scleral Lens Patients?","volume":"97","author":"Nguyen","year":"2020","journal-title":"Optom. Vis. Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/ICL.0000000000000755","article-title":"Efficiency and Safety of Scleral Lenses in Rehabilitation of Refractive Errors and High Order Aberrations After Penetrating Keratoplasty","volume":"47","author":"Penbe","year":"2021","journal-title":"Eye Contact Lens"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.clae.2017.10.010","article-title":"An Analysis of Anterior Scleral Shape and Its Role in the Design and Fitting of Scleral Contact Lenses","volume":"41","author":"Ritzmann","year":"2018","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"102174","DOI":"10.1016\/j.clae.2024.102174","article-title":"Image- and Impression-Based Technology for Scleral Lens Fitting for Keratoconus: Efficiency of the Fitting Process","volume":"47","author":"Shorter","year":"2024","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.clae.2018.02.003","article-title":"The Influence of Limbal and Scleral Shape on Scleral Lens Design","volume":"41","author":"Fadel","year":"2018","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1097\/ICL.0000000000000676","article-title":"Regional Variations in Postlens Tear Layer Thickness during Scleral Lens Wear","volume":"46","author":"Vincent","year":"2020","journal-title":"Eye Contact Lens"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.clae.2018.03.001","article-title":"The Time Course and Nature of Corneal Oedema during Sealed Miniscleral Contact Lens Wear","volume":"42","author":"Vincent","year":"2019","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1167\/iovs.18-24664","article-title":"Identification of Leukocytes Associated with Midday Fogging in the Post-Lens Tear Film of Scleral Contact Lens Wearers","volume":"60","author":"Postnikoff","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.clae.2020.09.001","article-title":"Conjunctival Prolapse during Open Eye Scleral Lens Wear","volume":"44","author":"Fisher","year":"2021","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.clae.2012.12.006","article-title":"Utility of a Semi-Scleral Contact Lens Design in the Management of the Irregular Cornea","volume":"36","year":"2013","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1080\/08164622.2022.2097858","article-title":"What We Know about the Scleral Profile and Its Impact on Contact Lens Fitting","volume":"106","author":"Frogozo","year":"2023","journal-title":"Clin. Exp. Optom."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/01.icl.0000233217.68379.d5","article-title":"Modern Scleral Lenses Part I: Clinical Features","volume":"33","author":"Visser","year":"2007","journal-title":"Eye Contact Lens"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1097\/OPX.0000000000001578","article-title":"Safety and Efficacy of Scleral Lenses for Keratoconus","volume":"97","author":"Fuller","year":"2020","journal-title":"Optom. Vis. Sci."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/ICL.0000000000000083","article-title":"Scleral Lenses: A Literature Review","volume":"41","author":"Schornack","year":"2015","journal-title":"Eye Contact Lens"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.clae.2014.02.002","article-title":"Modern Scleral Contact Lenses: A Review","volume":"37","author":"Bornman","year":"2014","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.clae.2018.10.020","article-title":"Scleral Lens Fitting and Assessment Strategies","volume":"42","author":"Harthan","year":"2019","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1097\/ICL.0b013e3181eb8418","article-title":"Relationship between Corneal Topographic Indices and Scleral Lens Base Curve","volume":"36","author":"Schornack","year":"2010","journal-title":"Eye Contact Lens"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"6","DOI":"10.12688\/f1000research.74638.1","article-title":"A Multi-Parameter Grading System for Optimal Fitting of Scleral Contact Lenses","volume":"11","author":"Kumar","year":"2022","journal-title":"F1000Res"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"101380","DOI":"10.1016\/j.clae.2020.10.010","article-title":"Multicenter Review of Impression-Based Scleral Devices","volume":"44","author":"Nau","year":"2021","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.clae.2020.06.005","article-title":"Anatomical and Physiological Considerations in Scleral Lens Wear: Conjunctiva and Sclera","volume":"43","author":"Walker","year":"2020","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.optom.2018.10.002","article-title":"In Vivo Assessment of the Anterior Scleral Contour Assisted by Automatic Profilometry and Changes in Conjunctival Shape after Miniscleral Contact Lens Fitting","volume":"12","year":"2019","journal-title":"J. Optom."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"S259","DOI":"10.1097\/ICL.0000000000000401","article-title":"SMap3D Corneo-Scleral Topographer Repeatability in Scleral Lens Patients","volume":"44","author":"DeNaeyer","year":"2018","journal-title":"Eye Contact Lens"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/opo.12587","article-title":"Scleral Asymmetry as a Potential Predictor for Scleral Lens Compression","volume":"38","author":"Consejo","year":"2018","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1097\/OPX.0000000000001570","article-title":"Optical Quality and Visual Performance for One Year in a Sample of Scleral Lens Wearers","volume":"97","author":"McAllinden","year":"2020","journal-title":"Optom. Vis. Sci."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1097\/OPX.0000000000001577","article-title":"The Impact of Misaligned Wavefront-Guided Correction in a Scleral Lens for the Highly Aberrated Eye","volume":"97","author":"Rijal","year":"2020","journal-title":"Optom. Vis. Sci."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"79","DOI":"10.2147\/TCRM.S293425","article-title":"Effects of Scleral Contact Lenses for Keratoconus Management on Visual Quality and Intraocular Pressure","volume":"17","author":"Formisano","year":"2021","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/ICL.0000000000000919","article-title":"Benefits of Scleral Lens in the Management of Irregular Corneas and Dry Eye Syndrome After Refractive Surgery","volume":"48","author":"Marty","year":"2022","journal-title":"Eye Contact Lens"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.4103\/IJO.IJO_1820_23","article-title":"Aberration Change after Scleral Lens Wear in Eyes with Pellucid Marginal Degenerations","volume":"72","author":"Dutta","year":"2024","journal-title":"Indian J. Ophthalmol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1364\/JOSAA.18.001003","article-title":"Effect of Rotation and Translation on the Expected Benefit of an Ideal Method to Correct the Eye\u2019s Higher-Order Aberrations","volume":"18","author":"Guirao","year":"2001","journal-title":"J. Opt. Soc. Am. A Opt. Image Sci. Vis."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1364\/JOSAA.19.000126","article-title":"Method for Optimizing the Correction of the Eye\u2019s Higher-Order Aberrations in the Presence of Decentrations","volume":"19","author":"Guirao","year":"2002","journal-title":"J. Opt. Soc. Am. A Opt. Image Sci. Vis."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2147\/OPTO.S284634","article-title":"Midday Fogging of Scleral Contact Lenses: Current Perspectives","volume":"13","author":"Fogt","year":"2021","journal-title":"Clin. Optom."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.clae.2019.10.140","article-title":"A One-Year Prospective Study on Scleral Lens Wear Success","volume":"43","year":"2020","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.clae.2020.03.005","article-title":"Factors Associated with Patient-Reported Midday Fogging in Established Scleral Lens Wearers","volume":"43","author":"Schornack","year":"2020","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.clae.2015.08.003","article-title":"Complications and Fitting Challenges Associated with Scleral Contact Lenses: A Review","volume":"39","author":"Walker","year":"2016","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1111\/cxo.12519","article-title":"Quality of Life and Handling Experience with the PROSE Device: An Indian Scenario","volume":"100","author":"Bhattacharya","year":"2017","journal-title":"Clin. Exp. Optom."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/10\/1051\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:10:57Z","timestamp":1760112657000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/10\/1051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,11]]},"references-count":100,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["jpm14101051"],"URL":"https:\/\/doi.org\/10.3390\/jpm14101051","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,11]]}}}