Objective:

To discuss the critical importance of oxygen delivery and tear exchange in maintaining corneal health during scleral lens wear.

Key Findings:

• Fenestrations and channels can improve corneal oxygenation and reduce edema, but their efficacy varies.
• Some complications from corneal hypoxia still occur, particularly in patients with endothelial abnormalities.
• Fenestrated scleral lenses can help manage handling difficulties and other complications associated with lens wear, but careful patient selection is crucial.

Interpretation:

While advancements in scleral lens designs have improved outcomes, careful consideration is needed for individuals with endothelial abnormalities to mitigate hypoxia-related issues, emphasizing the need for tailored patient care.

Limitations:

• Evidence for the efficacy of fenestrations and channels is not conclusive, particularly in certain patient populations.
• Complications may still arise in patients with specific corneal conditions, necessitating further investigation.

Conclusion:

Fenestrated scleral lenses offer potential benefits for corneal health, but further research is needed to fully understand their impact and optimize patient outcomes.