Scleral Lens Use in Neurotrophic Keratopathy: A Review of Current Concepts and Practice.

OBJECTIVE Neurotrophic keratopathy (NK) is a rare corneal condition characterized by epitheliopathy, which is associated with reduced or absent corneal sensation. The main goal of treatment of this condition is the preservation of ocular surface integrity. Contact lenses provide a nonsurgical and reversible option to provide the necessary corneal protection. The purpose of this review was to summarize the available literature regarding the use of contact lenses in the management of NK, with particular emphasis on the use of scleral lenses. METHODS Literature related to both soft and scleral contact lens use as treatment options for NK was reviewed. RESULTS As of yet, randomized clinical trials have compared neither the efficacy of contact lens therapy for NK to other therapeutic alternatives nor outcomes of therapy with different contact lens modalities. However, clinical case reports and limited case series have suggested that scleral lenses may be a safe and effective treatment option for NK at any stage of the disease, preserving epithelial integrity and even improving visual function in patients with this condition. CONCLUSIONS Scleral lenses may be effective in reducing the need for surgical intervention and improving the quality of life in patients with NK.

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