AAOpt 2025: Multi-country real-world evaluation of a custom scleral lens system

Karen Hoffman, OD, presented a poster titled "Multi-country real-world evaluation of a custom scleral lens system" during this year's American Academy of Optometry Academy meeting. The poster focused on fitting practice, clinical outcome, and practitioner satisfaction data from a study that examined complex patient cases and the effectiveness of a customized lens approach.

The research revealed positive outcomes despite the challenging patient profiles. One of the most significant findings was the minimal lens modifications required - just 1.8 modifications per lens. This is particularly impressive considering the complexity of the patients, many of whom had conditions like keratoconus. The customization techniques employed were sophisticated, including torque peripheral curves, quadrant-specific peripheral curves, dual elevations, and even multifocal lens designs. Visual outcomes were exceptionally strong, with 92% of patients achieving 20/40 vision or better. Wearing comfort was also excellent, with patients able to comfortably wear the lenses for an average of 13 hours. These metrics underscore the effectiveness of the custom scleral lens system in addressing diverse patient needs.

Practitioner satisfaction was another critical aspect of the study. Eye care professionals reported high levels of satisfaction across multiple dimensions, including lens outcome, fitting process, and the ease of making lens modifications. This feedback is crucial, as it reflects the system's practicality and effectiveness from the clinician's perspective.

Hoffman's personal reflection added depth to the findings. She shared her initial hesitation about extensive lens customization early in her career, contrasting it with the study's demonstration that complex lens modifications can be performed straightforwardly and effectively. The study's key message is clear: practitioners should not be intimidated by complex cases or extensive lens customization. By embracing advanced fitting techniques and leveraging customized lens systems, eye care professionals can significantly improve patient outcomes. This research provides valuable insights into the potential of custom scleral lens systems, offering both clinicians and patients a promising approach to managing challenging vision correction scenarios.