Keratoconus is a disease that makes the cornea, thinner and causes bulge out in a cone shape. This causes blurry vision, glare, and light sensitivity, difficult to open the eye in bright light, difficult to drive etc . Keratoconus is most of the time associated with dry eye
irritation, headache etc. as it difficult to correct with spectacle and regular lenses. For treating keratoconus, two most common choices are customised scleral lenses and Implantable Collamer Lenses (ICL) which are used.
To know about the best options for keratoconus that prioritise your needs, let’s breakdown
difference between Implantable Collamer Lenses (ICL) and customised scleral lenses.
Here’s a comparison to help you understand which option might suit your needs.
1. Irregular Cornea
The corneal irregular shape is one of the primary problems associated with keratoconus. Glasses and normal contact lenses often do not overcome this problem in term of comfort and clarity of vision also when disease is severe.
Scleral lenses are placed on the conjunctiva overlying the scleral of the eye by vaulting the cornea and by filling the lens with preservative free saline. This saline act as tear reservoir which neutralize the irregular corneal surface created by disease and provide comfortable and clear vision.
On the other hand ICL is implanted inside the eye. ICL when placed in conditions like these cannot mask the irregular corneal shape and can correct refractive error up to some extent. Hence, the completer vision clarity cannot be corrected with ICL and some form of resultant refractive error is expected.
2. Effective for any stage of keratoconus
Keratoconus is a progressive disorder; hence treatment has to change as the disease progresses.
Scleral lenses are suitable and can be customized as per mild, moderate, and severe keratoconus.
They are useful for advanced keratoconus where the cornea is very uneven. Also, these lenses can be combined with treatment like as corneal cross-linking (CXL).
ICL is commonly suggested for stable keratoconus following CXL. It works well in mild to moderate cases, but it struggles to treat severe keratoconus in which cornea is severely uneven.
3. Vision quality
Scleral lenses frequently surpass ICL in terms of vision clarity.
With scleral lenses the fluid layer behind the lens smoothens the cornea’s uneven surface, correcting irregular astigmatism and providing clear, stable vision. They also keep the eyes moist, which reduces dryness and irritation.
ICL takes care of refractive errors associated with keratoconus, however it does not treat irregular corneal shapes and cannot help in dryness caused by the same. Also, there are chances that patients may experience blurred vision, glare, or halos, particularly in low-light conditions.
4. Need for Surgery
Scleral Lenses do not need surgery. And are easy to wear and remove. Scleral lenses can be changed or replaced as your visual demands.
Whereas, ICL is a surgical procedure as it needs to be implanted inside the eye. Although the operation is regarded as safe. Also in near future if you wish to remove or replaced it needs another surgical procedure.
5. Comfort
Comfort plays an important role when it comes to irregular corneal condition because of the increase in corneal sensitivity.
As we know scleral lenses sit on the sclera which is less sensitive than the cornea, the lenses are extremely comfortable. These lenses also reduces the dryness and irritation as lid does not rub the cornea.
While, ICL are directly implanted inside the eye so they are super comfortable too once the eye settles. But dryness and irritation associated with keratoconus cannot be overcome by ICL.
6. Affordability and Flexibility
Scleral lenses are a better choice in terms of long-term affordability and flexibility. Scleral lenses might cost more at first, but they can be changed or replaced whenever required.
Whereas ICL surgery costs a little more, and if it needs to be replaced, the total cost goes up. Making changes with ICL always needs more surgery, which raises the cost.
7. Safe for Long-Term Use
Scleral lenses are safe for long-term use because they do not change the shape of the eye. And the complications with scleral lenses are easy to treat. Simply discontinuing the lens and starting the medicine as per consultant resolves the issue.
ICL on the other hand carries long-term risks such as cataracts or the loss of cells in the cornea. Sometime the complications are irreversible when the intra ocular pressure rises the condition is called glaucoma. To prevent such complications frequent follow up needs to be maintained.
8. Corneal Lenses Fails
When other type of corneal lenses, like RGP Contact lens, Rose K2 contact lens, Piggy back contact lens and Hybrid lenses fails to provide quality of vision scleral lenses come to the rescue.
Whereas ICL will always remain a surgical option in mild to moderate cases.
Conclusion:
Customised scleral lenses are definitely the better choice for patients with keratoconus. They provide clear crisper vision, with comfort, and safety without surgery and patient can wear this lens at any stage of keratoconus. The most important expect of this lens is that it needs proper customization to align with patients need. Whereas ICL can remain as an option but with its own kind of hit and miss.
At Reform Vision, we focus on creating customized scleral lenses that are specific to each patient’s needs. Our expert staff is committed to assist you in achieving your vision.
If you want to take control of your keratoconus and achieve clear, comfortable vision, schedule a consultation now and learn about the life-changing benefits of scleral lenses and other corneal lenses.