Scleral Trends: Mini-Scleral Designs and Toric Landing Zones
Discover insights from a recent retrospective study on prescribing trends in a high-volume Netherlands-based contact lens clinic, revealing a shift towards mini-scleral designs and the use of toric landing zones.
Clinical Scorecard: Scleral Trends: Mini-Scleral Designs and Toric Landing Zones
At a Glance
Category Detail
Condition Scleral lens fitting Key Mechanisms Transition from large-diameter to mini-scleral lens designs; use of toric landing zones reflecting anatomical scleral shape. Target Population Patients requiring scleral lenses, particularly those with keratoconus and other corneal irregularities. Care Setting High-volume specialty contact lens clinics.
Key Highlights
60.8% of scleral lenses prescribed were mini-scleral designs. Use of mini-scleral lenses increased from 44% in 2016 to 74% in 2022. 99.8% of scleral lens fittings utilized toric landing zones. Mean number of lenses required for successful fitting was 1.4 ± 0.7. The introduction of bi-tangential mini-scleral lenses in 2018 improved fitting outcomes. Guideline-Based Recommendations
Diagnosis
Utilize diagnostic fitting sets for accurate scleral lens fitting. Management
Consider mini-scleral designs for most patients, except those who have undergone keratoplasty. Monitoring & Follow-up
Track fitting success rates and lens re-orders to optimize patient outcomes. Risks
Inadequate fitting may lead to discomfort or complications; ensure toric landing zones are used. Patient & Prescribing Data
6,635 unique patients, median age 43 years.
Younger patients with keratoconus had a median age of 35 years; mini-scleral lenses are preferred for most indications.
Clinical Best Practices
Employ the Visser fitting philosophy for scleral lens fittings. Monitor the anatomical scleral shape to determine the need for toric landing zones. Leverage practitioner experience to reduce the number of lenses needed for successful fittings. References
