Clinical Report: Scleral Lenses as Drug Delivery Systems

Overview

Recent studies highlight the efficacy of scleral lenses as drug delivery systems, particularly for conditions like dry eye disease and persistent epithelial defects. Notable findings include significant improvements in ocular surface health with preservative-free cyclosporine and autologous serum tears.

Background

Scleral lenses have emerged as a promising therapeutic option for various ocular surface diseases, offering sustained drug delivery and improved bioavailability. Their use as drug delivery systems is gaining attention, particularly for patients with refractory conditions where traditional treatments may fall short. Understanding the clinical applications and outcomes associated with scleral lenses is crucial for optimizing patient care.

Data Highlights

No numerical data available in the provided source.

Key Findings

• Scleral lenses can effectively deliver preservative-free cyclosporine 0.05%, resulting in significant improvement in ocular surface disease metrics.
• Autologous serum tears used in scleral lenses have shown faster healing rates for persistent epithelial defects compared to soft bandage lenses.
• Prophylactic antibiotics can be administered via scleral lenses without increasing the risk of microbial keratitis.
• Compounded amphotericin B instilled in scleral lenses has been effective in treating Candida keratitis.
• Anti-VEGF therapy using scleral lenses has demonstrated regression of corneal vascularization in several cases.

Clinical Implications

Clinicians should consider scleral lenses as a viable option for drug delivery in patients with complex ocular surface diseases. Careful patient selection and adherence to hygiene protocols are essential to mitigate the risks associated with extended wear and off-label drug use.

Conclusion

Scleral lenses represent a novel approach to drug delivery in ophthalmology, with emerging evidence supporting their use in various therapeutic contexts. Continued research is needed to establish standardized protocols and safety measures.

References

1. Nakhla MN, Patel R, Crowley E, et al., Clin Ophthalmol, 2024 -- Utilizing PROSE as a Drug Delivery Device for Preservative-Free Cyclosporine 0.05% for the Treatment of Dry Eye Disease: A Pilot Study
2. Harthan JS, Shorter E, Clin Optom (Auckl), 2018 -- Therapeutic uses of scleral contact lenses for ocular surface disease: patient selection and special considerations
3. Frogozo M, Contact Lens Update, 2022 -- Use of a scleral contact lens to manage a patient with a persistent epithelial defect due to neurotrophic keratitis
4. Ciralsky JB, et al., Clin Ophthalmol, 2015 -- Treatment of refractory persistent corneal epithelial defects
5. Rykowska I, et al., Molecules, 2021 -- Soft contact lenses as drug delivery systems: a review
6. Corneal Physician — Therapeutic Applications of Scleral Lenses
7. Contact Lens Spectrum — CONTACT LENS DESIGN & MATERIALS
8. Contact Lens Spectrum — Refractive Focus
9. Contact Lens Spectrum — Refractive Focus
10. Therapeutic Applications of Scleral Lenses
11. CONTACT LENS DESIGN & MATERIALS
12. Dry Eye Syndrome Preferred Practice Pattern®
13. Utilizing PROSE as a Drug Delivery Device for Preservative-Free Cyclosporine 0.05% for the Treatment of Dry Eye Disease: A Pilot Study - PMC