Impact of Scleral Contact Lens Use on the Rate of Corneal Transplantation for Keratoconus

Jennifer J Ling; Shahzad I Mian; Joshua D Stein; Moshiur Rahman; Joel Poliskey; Maria A Woodward

doi:10.1097/ICO.0000000000002388

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Impact of Scleral Contact Lens Use on the Rate of Corneal Transplantation for Keratoconus

Journal article

Peer reviewed

Impact of Scleral Contact Lens Use on the Rate of Corneal Transplantation for Keratoconus

Jennifer J Ling, Shahzad I Mian, Joshua D Stein, Moshiur Rahman, Joel Poliskey and Maria A Woodward

Cornea, Vol.40(1), pp.39-42

01/2021

DOI: 10.1097/ICO.0000000000002388

PMCID: PMC7686092

PMID: 32452985

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https://www.ncbi.nlm.nih.gov/pmc/articles/7686092View

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Abstract

To evaluate the association of scleral contact lens (SCL) use on the risk for keratoplasty for people with keratoconus. The electronic health records of patients receiving eye care at the University of Michigan Kellogg Eye Center between August 1, 2012, and December 31, 2018, were reviewed. Patients with a diagnostic code of keratoconus or corneal ectasia, no previous history of keratoplasty, and for whom data were available for both eyes were included. Using a multivariable Cox regression model, associations between SCL use and keratoplasty were tested and adjusted for sociodemographic factors, maximum keratometry, and current contact lens (CL) use. Two thousand eight hundred six eyes met the inclusion criteria. CL use in each eye was 36.2% with no CL, 7.2% soft, 33.9% rigid gas permeable (RGP), and 22.7% scleral. A total of 3.2% of eyes underwent keratoplasty. In the adjusted model, SCL or RGP CL use significantly lowered the hazard of undergoing keratoplasty (HR = 0.19, 95% confidence interval [CI] 0.09-0.39, P < 0.0001 and HR = 0.30, 95% CI 0.17-0.52, P < 0.0001, respectively) when compared with no CL use. Factors associated with increased risk of keratoplasty were black race as compared to white (HR = 1.87, 95% CI 1.10-3.16, P = 0.02), younger age (HR = 0.92 per 5-year increment, 95% CI 0.86-0.99, P = 0.032), and lower socioeconomic status (HR = 1.08 per 5-point increase in the Area Deprivation Index, 95% CI 1.03-1.13, P = 0.0008). Keratoplasty was not associated with sex, insurance, or maximum keratometry. Physicians should maximize the use of scleral or RGP CL because patients who successfully use CL have almost one-fifth the risk of undergoing keratoplasty.

Details

Title: Subtitle: Impact of Scleral Contact Lens Use on the Rate of Corneal Transplantation for Keratoconus
Creators: Jennifer J Ling - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI
Shahzad I Mian - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI
Joshua D Stein - Department of Health Management Policy, University of Michigan School of Public Health, Ann Arbor, MI; and
Moshiur Rahman - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI
Joel Poliskey - University of Michigan School of Medicine, Ann Arbor, MI
Maria A Woodward - Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
Resource Type: Journal article
Publication Details: Cornea, Vol.40(1), pp.39-42
DOI: 10.1097/ICO.0000000000002388
PMID: 32452985
PMCID: PMC7686092
NLM abbreviation: Cornea
ISSN: 0277-3740
eISSN: 1536-4798
Grant note: R01 EY031033 / NEI NIH HHS
Language: English
Date published: 01/2021
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9984111975002771

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