Scleral Lenses: Jupitor or Prose Scleral Lenses For Dry Eye and Keratoconus. How Much do Scleral Lenses Cost? How Much does the Jupitor or Prose Scleral Lens Cost?

Scleral Lenses: 
Jupiter or Prose Scleral Lenses For 
Dry Eye (or Keratoconus). 
How Much do Scleral Lenses Cost? 
How Much does the Jupiter or Prose Scleral Lens Cost?

Scleral Lenses can help treat severe dry eye. 
The cost of getting a Prose Scleral Lens is about $5000-$10,000 not including room and board to fly to particular centers who fit the Prose Lens.
We use the Jupiter Scleral Lens which achieves similar results in most patients, though I do not see any randomized controlled trial to compare Prose and Jupiter Scleral Lenses yet. 
More information on Scleral Lenses Below.
We charge between $2200-2500 for a Scleral Lenses for our patients. We have had years of experience using scleral lenses for Keratoconus patients with excellent results. We have been using scleral lenses for our dry eye patients now for two years with excellent results as well. Some insurance will cover scleral lenses if we can show an improvement in vision as a medical necessity. Some insurances will not cover them no matter what documentation we provide. 
We refund 80% of the cost of the scleral lens (approximately $1200-1500) if a patient is unhappy with the lens and returned within 90 days of purchase. The fitting cost (approximately $1000) is not refundable. 

Scleral Lens on the Left Compared to Rigid Gas Permeable on the Right
Several corneal abnormalities, such as corneal degenerations, such as Keratoconus noted below, ectasias, dystrophies, keratoconjunctivitis sicca and severe dry eye can result in decreased visual acuity
due either to irregular astigmatism or corneal opacities. 
The
management of these patients includes many options as discussed in previous posts (https://drcremers.com/2016/10/best-treatment-for-dry-eyes-eye-redness.html) but it may also include fitting corneal rigid contact lenses. However, fitting these lenses in
advanced cases can be challenging as a result of lens decentration,
dislocation, or pain/discomfort and cost: the Prose is expsensive. In some cases, surgery may be the next option for those
patients that cannot be fit or are unable to tolerate contact lenses.
Modern scleral lenses offer a new alternative for patients who have
not had success with other lens types. 
Scleral Lenses were first
reported in 1888 by Adolph Fick and have now been reintroduced in
newer, better tolerated materials. The manufacturing process for scleral lenses has
been improved, and larger lens diameters can now be accurately
reproduced and more comfortable.
Scleral Lenses are customized to fit your eye as perfectly as possible: diameter, base curve, peripheral curve and power are carefully measured for each eye.
Scleral lenses are large diameter gas permeable lenses that rest
beyond the limits of the cornea on the sclera. Successful fitting of
scleral lenses may defer surgical intervention and decrease the risk
of corneal scarring. Scleral lenses may be indicated for primary
and secondary corneal ectasias, like Keratoconus, post-corneal transplants, and severe dry eye patients. 
Sandra Lora Cremers, MD, FACS
 2015 Jul;26(4):319-24. doi: 10.1097/ICU.0000000000000171.

Scleral lens use in dry eye syndrome.

Abstract

PURPOSE OF REVIEW:

Dry eye syndrome can be difficult to manage in severe or refractory cases. In patients in whom traditional treatments have limited efficacy, alternative treatments may be considered for dry eye syndrome, including scleral lenses. The present review summarizes the evidence regarding scleral lens use in dry eye syndrome.

RECENT FINDINGS:

Scleral lenses have become a viable option for severe dry eye syndrome, and have been shown to be efficacious and well tolerated, with most reports citing improved visual acuity and relief of symptoms. Currently, there are 18 manufacturers of scleral lenses, although published reports on scleral lenses primarily focus on the BostonSight PROSE and the Jupiter Lens.

SUMMARY:

Scleral lenses are efficacious and well tolerated for use in severe dry eye syndrome. Further research is needed to compare different sizes and types of lenses, and to standardize outcome measures.

As of October 2016 there are 4 papers on Jupiter and Prose Scleral Lens for Dry Eye but none that really compare the types of Scleral Lenses head to head.

Bavinger JC, DeLoss K, Mian SI.
Curr Opin Ophthalmol. 2015 Jul;26(4):319-24. doi: 10.1097/ICU.0000000000000171. Review.
PMID:

 

26058032
2.
Schornack MM, Patel SV.
Eye Contact Lens. 2010 Nov;36(6):330-3. doi: 10.1097/ICL.0b013e3181eb8418.
PMID:

 

20631627
3.
Schornack MM, Baratz KH, Patel SV, Maguire LJ.
Eye Contact Lens. 2008 Nov;34(6):302-5. doi: 10.1097/ICL.0b013e318188e205.
PMID:

 

18997537
4.
Ye P, Sun A, Weissman BA.
Eye Contact Lens. 2007 Mar;33(2):111-3.
PMID:

 

17496707
Sivaraman KR, Jivrajka RV, Soin K, Bouchard CS, Movahedan A, Shorter E, Jain S, Jacobs DS, Djalilian AR.
Ocul Surf. 2016 Jul;14(3):393-400. doi: 10.1016/j.jtos.2016.04.003. Epub 2016 May 12.
PMID:

 

27179980
2.
Bavinger JC, DeLoss K, Mian SI.
Curr Opin Ophthalmol. 2015 Jul;26(4):319-24. doi: 10.1097/ICU.0000000000000171. Review.
PMID:

 

26058032
3.
Wang Y, Kornberg DL, St Clair RM, Lee M, Muhic I, Ciralsky JB, Alzaga Fernandez A, Sood P, Sippel KC, Rosenblatt MI.
Cornea. 2015 Apr;34(4):427-32. doi: 10.1097/ICO.0000000000000381.
PMID:

 

25710510

 

Free PMC Article

4.
Dimit R, Gire A, Pflugfelder SC, Bergmanson JP.
Cont Lens Anterior Eye. 2013 Aug;36(4):159-63. doi: 10.1016/j.clae.2013.02.004. Epub 2013 Mar 15.
PMID:

 

23499361
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