Managing Persistent Scleral Lens Intolerance in Post-LASIK Ectasia

By
Andrew PIckens, OD
September 17, 2026
4 min

Contact Lens Spectrum

Background

Scleral lenses are increasingly used for managing irregular corneas, particularly in patients with conditions like post-LASIK ectasia. Understanding the factors contributing to lens intolerance is crucial for optimizing patient outcomes. Material selection, particularly oxygen transmissibility, plays a significant role in the comfort and success of scleral lens wear, as supported by recent studies.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

A 46-year-old female with post-LASIK ectasia experienced persistent discomfort with scleral lenses.
Initial scleral lenses had a Dk value of 141 and a thickness of 0.35 mm.
After refitting with Onefit MED lenses made from Optimum Infinite material (Dk value of 180), the patient reported improved comfort.
Wearing time increased from less than an hour to 8 hours, with visual acuity improving to 20/20 OD and 20/25 OS.
The patient was able to discontinue all dry eye treatments and now uses OTC allergy drops once daily.
Material selection is critical in managing scleral lens intolerance, especially in patients with chronic ocular surface inflammation.

Clinical Implications

Practitioners should consider lens material and oxygen transmissibility when addressing scleral lens intolerance. A thorough assessment of the patient's ocular surface and previous lens performance can guide effective refitting strategies based on clinical findings.