SynthesisOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2026
Corneal and Intraocular Pressure Responses to Scleral Lens Wear: A Meta-Analysis.
Synthesis in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the effects of scleral contact lens wear on central corneal thickness, corneal or stromal swelling and intraocular pressure, and to identify factors that may influence these outcomes.
methodsA systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the AMSTAR-2 quality assessment tool (registration number PROSPERO CRD420251141392). The PubMed, Web of Science and Scopus databases were searched without language or date restrictions. Eligible studies included prospective, observational, controlled or crossover designs assessing physiological changes during or after scleral contact lens wear. Mean differences with 95% confidence intervals (CIs) were pooled using random- or fixed-effects models. Heterogeneity was quantified using the I-squared statistic, and meta-regressions examined the influence of lens and patient-level factors.
resultsTwenty-two studies, including 830 eyes, were analysed. Scleral contact lens wear produced a small but statistically significant increase in central corneal thickness while the lens was in place (mean difference: 7.93 µm; 95% CI: 4.92-10.95; p < 0.001; I² = 0%) and no significant change after lens removal (mean difference: 1.49 µm; p = 0.34). Corneal or stromal swelling showed a small increase of 0.88% (p < 0.001; I² = 83%), consistent with the small magnitude and variability of these changes across studies. Intraocular pressure after lens removal showed no significant variation (mean difference: 0.38 mmHg; p = 0.27; I² = 78%).
conclusionsScleral contact lens wear induces minimal and largely reversible changes in corneal thickness and intraocular pressure. Daytime wear of modern high-oxygen-permeable lenses appears to be physiologically safe, although selective monitoring remains advisable in high-risk patients.
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