Corneal and Intraocular Pressure Responses to Scleral Lens Wear: A Meta-Analysis

Purpose To evaluate the effects of scleral contact lens wear on central corneal thickness, corneal or stromal swelling and intraocular pressure, and to identify factors that may influence these outcomes. Methods A systematic review and meta-analysis was conducted according to the Preferred Reporting...

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Detalhes bibliográficos
Autores: Martínez Pérez, Clara, Sánchez González, María Carmen, Sánchez-González, José-María
Formato: artículo
Fecha de publicación:2026
País:España
Recursos:Universidad de Santiago de Compostela (USC)
Repositorio:Minerva. Repositorio Institucional de la Universidad de Santiago de Compostela
Idioma:inglés
OAI Identifier:oai:dnet:minerva_____::c8e289e6a874dcaf92f711af4564b1e7
Acesso em linha:https://hdl.handle.net/10347/47509
Access Level:acceso abierto
Palavra-chave:Central corneal thickness
Corneal oedema
Contact lens complication
Intraocular pressure
Oxygen permeability
Scleral lenses
Descrição
Resumo:Purpose To evaluate the effects of scleral contact lens wear on central corneal thickness, corneal or stromal swelling and intraocular pressure, and to identify factors that may influence these outcomes. Methods A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the AMSTAR-2 quality assessment tool (registration number PROSPERO CRD420251141392). The PubMed, Web of Science and Scopus databases were searched without language or date restrictions. Eligible studies included prospective, observational, controlled or crossover designs assessing physiological changes during or after scleral contact lens wear. Mean differences with 95% confidence intervals (CIs) were pooled using random- or fixed-effects models. Heterogeneity was quantified using the I-squared statistic, and meta-regressions examined the influence of lens and patient-level factors. Results Twenty-two studies, including 830 eyes, were analysed. Scleral contact lens wear produced a small but statistically significant increase in central corneal thickness while the lens was in place (mean difference: 7.93 µm; 95% CI: 4.92–10.95; p < 0.001; I² = 0%) and no significant change after lens removal (mean difference: 1.49 µm; p = 0.34). Corneal or stromal swelling showed a small increase of 0.88% (p < 0.001; I² = 83%), consistent with the small magnitude and variability of these changes across studies. Intraocular pressure after lens removal showed no significant variation (mean difference: 0.38 mmHg; p = 0.27; I² = 78%). Conclusions Scleral contact lens wear induces minimal and largely reversible changes in corneal thickness and intraocular pressure. Daytime wear of modern high–oxygen-permeable lenses appears to be physiologically safe, although selective monitoring remains advisable in high-risk patients.