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Level of reactive oxygen species in keratoconic eyes wearing scleral lenses

Clin Exp Optom. 2025 Nov 13:1-11. doi: 10.1080/08164622.2025.2578336. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: Oxidative stress and elevated reactive oxygen species (ROS) are implicated in corneal pathologies such as keratoconus. Understanding how scleral lens (SL) wear influence these mechanisms is important for optimizing patient management.

BACKGROUND: To assess the alteration in ROS level of keratoconic eyes wearing SL.

METHODS: Ocular surface tears (T0) were collected at baseline and 6 hours of lens wear (T6) on Day 1 and 1 month from 26 keratoconic eyes. SL fluid reservoir (SLFR) was collected after 6 hours of lens wear on Day 1 (SLFR Day 1) and at 1 month (SLFR 1 month). ROS levels were measured using fluorimetry from Schirmer’s strip tear samples and the SLFR samples. Visual acuity, Schirmer’s values, and Ocular Surface Disease index questionnaire was also assessed.

RESULTS: The ROS levels of T0 1 month showed significant reduction after 6 hours of SL wear (p < 0.001). Similarly, the ROS level of SLFR decreased after 1 month of SL wear compared to Day 1 (p = 0.007). ROS level in SLFR at Day 1 and 1 month showed significant reduction when compared to T0 1 month value (p = 0.002, p < 0.001 respectively). A statistically significant increase in T0 value was noted at 1 month time point when compared to day 1 values (p = 0.005). The baseline ROS levels were higher in collagen cross-linked eyes (p = 0.01), while non-collagen cross-linked eyes showed a reduction in ROS levels of SLFR (p = 0.01) after 1 month of SL wear. Visual acuity and ocular surface disease index score showed significant improvement after 6 hours and 1 month compared to baseline (p < 0.001 and p < 0.001).

CONCLUSION: ROS level reduced in the SLFR after 1 month and in tears after 6 hours with SL in KC patients. This indicates the effectiveness of SL in reducing ROS level of SLFR which might have association with keratoconus pathogenesis, warrants further analysis.

PMID:41232020 | DOI:10.1080/08164622.2025.2578336

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