Following the completion of the scleral lens fit, the epithe-lial defect resolved within 10 days and has not recurred.Conclusion: Scleral rigid gas permeable lenses are nowcommercially available in the U.S. Unlike corneal lenses,scleral lenses completely vault the corneal surface, andmaintain a reservoir of fluid between the posterior surface ofthe lens and the anterior cornea. These fitting characteristicsreduce lens awareness, and support and maintain epithelialintegrity. While eye care providers can manage most ocularconditions with more commonly used contact lenses, sclerallenses allow us to improve visual function, increase patientcomfort, and better maintain the ocular surface in cases thatcannot be effectively managed with other lens designs.

Poster 10

Management of Keratoglobus With Boston Scleral Lens:A Pediatric Case SeriesAndrew McLeod, O.D., M.S., and Lynette Johns, O.D.,New England School of Optometry, 424 Beacon Street,Boston, Massachusetts 02115

Background: Keratoglobus is a rare bilateral condition thatresults in a protrusion of the entire cornea, with significantlimbus-to-limbus ectasia. These corneal changes often leadto high myopia, irregular astigmatism, and possible scarringfrom hydrops. Present management includes spectacle cor-rection, contact lenses, and surgical intervention. Success isoften limited and variable with each technique. The BostonScleral Lens has been successful in our case series to showincreased, stable visual acuity without compromising theocular health.

The Boston Scleral Lens (Equalens II, Dk� 85) creates asaline-filled chamber between the back lens surface and theanterior cornea. The lacrimal lens created masks cornealirregularities, and the front lens surface provides a smoothoptical surface. Lenses do not rotate or move on blinkresulting in more stable vision.Case Reports: Patient 1 is a 6-year-old Caucasian male withentering uncorrected visual acuity of 20/400 O.D. and20/400 O.S. and with the scleral lens was improved to 20/40O.D. and 20/40- O.S. Patient 2 is 16-year-old Caucasianfemale with entering best-correct spectacle acuity of 20/400O.D. and 20/40- O.S., corrected with scleral lenses to 20/80O.D. and 20/20- O.S. Patient 3 is a 16-year-old Hispanicmale with entering best-corrected spectacle acuity of count-ing fingers O.D. and 20/200 O.S. Mild trauma at age 8 alsoleft this patient with a severe, permanent split in Descemetmembrane O.D. Visual acuity was improved to 20/80- O.D.and 20/40- O.S. Patient 4 is an 18-year-old Hispanic malewith entering best-correct spectacle acuity of counting fin-gers O.D. and 20/400 O.S. Acuities were improved to20/80� O.D. and 20/80� O.S. Patients 1 and 2 wererecently fit without complications and Patients 3 and 4 havebeen successful with lens wear for over 2 years. Long-termeffects are unknown.

Conclusion: The Boston Scleral Lens has shown to im-prove vision better than spectacles, is less invasive tosurgery, better fitting to regular gas permeable lenses,and does not compromise the ocular health. It is, there-fore, a noted option in the management of keratoglubus.

Poster 11

So-2: A Go-To Lens for Penetrating KeratoplastySecondary to KeratoconusElizabeth Sanders, O.D., and Andrea Janoff, O.D., NovaSoutheastern University, College of Optometry, 3200South University Drive, Ft. Lauderdale, Florida 33328

Background: A 64-year-old man presented for a gas-permeable lens fitting O.D., 25 years post penetratingkeratoplasty (PK) OU, secondary to keratoconus. Afterdispensing a well-fit intralimbal gas permeable (GP) lens,the patient complained of multiple episodes of spontane-ous lens ejection. So-2-Clear™, formerly the MacroLens™, a corneol-scleral GP design reintroduced with amodified edge profile by Acuity One, resulted in a suc-cessful fit with increased visual acuity and lens stability.Case Report: Presenting visual acuity with the patient’shabitual soft contact lens was 20/200 O.D. Corneal map-ping using the Medmont® E-300 Corneal Topographerrevealed simulated keratometry readings of 41.00 @ 150/ 47.40 @ 060, a horizontal visual iris diameter (HVID)of 11.2 mm and a characteristically abnormal ShapeFactor O.D. On slit lamp examination, a large diametergraft was observed with no signs of rejection. Moderatesuperficial punctate epithelial erosions were noted andthought to be due to the condition of the soft lens.Though the left eye had also undergone PK, with result-ing decreased visual acuity, the patient deferred a lensfitting in this eye due to a previous diagnosis of glau-coma. According to the manufacturer’s fitting guide, theappropriate starting base curve (BC) O.D. was 7.82 mm.Ultimately, the BC, which provided the recommendedcentral alignment with mid-peripheral clearance, was7.03 mm. Ideal peripheral clearance was noted with alens in a BC of 7.26 mm, which was recorded as thesecondary curve and manufactured with the requestedstandard aspheric peripheral curve (PC). The overalldiameter of the lens, extending approximately 1 mmbeyond the limbus as suggested, was 13.5 mm. With aback vertex power of -15.00D, the patient was able toachieve a best-corrected distance visual acuity of 20/30O.D. Using Boston XO, the standard SO-2-Clear™ lensmaterial, all day comfort was reported.Conclusion: Though post PK patients secondary to kerato-conus can prove challenging to fit, the So-2-Clear™ corne-al-scleral lens may offer greater comfort, fit, and overallpatient satisfaction when compared with traditional smallerGP lens designs.

274 Optometry, Vol 78, No 6, June 2007