Contact Lens Visual Rehabilitation in Keratoconus and Corneal Keratoplasty

Özkurt, Yelda Buyru; Atakan, Mehmet; Gencaga, Tugba; Akkaya, Sezen

doi:10.1155/2012/832070

Cited by 21 publications

(29 citation statements)

References 26 publications

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“… 5 Visual outcomes are comparable or even better than conventional RGP lenses in many patients. 1 , 6 , 7 Scleral and semiscleral lenses have proven to be extremely beneficial for patients with highly irregular and/or asymmetric keratoconic corneas, especially large diameter (13.5–16.0 mm) semiscleral lens designs. 7 Schornack showed a dramatic improvement in visual acuity by using scleral lens in a study.…”

Section: Introductionmentioning

confidence: 99%

Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

Alipur

Hosseini

2016

Journal of Current Ophthalmology

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PurposeTo evaluate visual results, comfort of use, safety, and efficacy of mini scleral contact lenses in optical management in patients with traumatic aphakia and severe concomitant irido-corneal injury.MethodsIn a case series, eight eyes with post traumatic aphakia and severe concomitant irido-corneal injury that were evaluated at the Contact Lens Clinic of Farabi Eye Hospital, Tehran, Iran for contact lens fitting and could not be corrected with conventional corneal RGP contact lenses were fitted with miniscleral contact lenses. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), and BCVA (Best corrected visual acuity) with miniscleral lens were recorded. Slit lamp examination, comfortable daily wearing time, and any contact lens-related complication were documented in each follow-up visit.ResultsThe mean UCVA and BSCVA of the cases was >2.7 and 0.41 LogMAR, respectively (BSCVA could not be assessed in one case due to severe corneal irregularity). The mean final BCVA with the miniscleral lens was 0.05 LogMAR (range from 0.4 to −0.04 LogMAR). The mean follow-up period was 14.6 months. The mean comfortable daily wearing time (CDWT) was 11.6 h, ranging from 8 to 16 h. The only contact lens-related complication was mild redness and irritation that was observed in 2 patients during the follow-up visits. All patients were comfortable with handling these lenses.ConclusionMiniscleral contact lenses can be considered a safe and effective option in aphakia patients with concurrent corneal scarring secondary to ocular injury for whom surgical intervention would be complicated.

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Section: Introductionmentioning

confidence: 99%

Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

Alipur

Hosseini

2016

Journal of Current Ophthalmology

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“…Both an apical-touch and three-point-touch fitting seem to reduce corneal asphericity and astigmatism and lower higher-order aberrations. However, they have implicated in the reduction of corneal basal epithelial cell and anterior stromal keratocyte densities [ 54 , 63 ].…”

Section: Discussionmentioning

confidence: 99%

Contact Lenses for Keratoconus- Current Practice

Moschos¹,

Nitoda²,

Georgoudis³

et al. 2017

Open Ophthal. J.

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Background:Keratoconus is a chronic, bilateral, usuallly asymmetrical, non-inflammatory, ectatic disorder, being characterized by progressive steepening, thinning and apical scarring of the cornea. Initially, the patient is asymptomatic, but the visual acuity gradually decreases, resulting in significant vision loss due to the development of irregular astigmatism, myopia, corneal thinning and scarring. The classic treatment of visual rehabilitation in keratoconus is based on spectacles and contact lenses (CLs).Objective:To summarize the types of CLs used in the treatment of keratoconus. This is literature review of several important published articles focusing on the visual rehabilitation in keratoconus with CLs.Method:Gas permeable (GP) CLs have been found to achieve better best corrected visual acuity than spectacles, eliminating 3rd-order coma root-mean-square (RMS) error, 3rd-order RMS, and higher-order RMS. However, they have implicated in reduction of corneal basal epithelial cell and anterior stromal keratocyte densities. Soft CLs seem to provide greater comfort and lower cost, but the low oxygen permeability (if the lens is not a silicone hydrogel), and the inability to mask moderate to severe irregular astigmatism are the main disadvantages of them. On the other hand, scleral CLs ensure stable platforms, which eliminate high-order aberrations and provide good centration and visual acuity. Their main disadvantages include the difficulties in application and removal of these lenses along with corneal flattening and swelling.Result:The modern hybrid CLs are indicated in cases of poor centration, poor stability or intolerance with GP lenses. Finally, piggyback CL systems effectively ameliorate visual acuity, but they have been related to corneal neovascularization and giant papillary conjunctivitis.Conclusion:CLs seem to rehabilitate visual performance, diminishing the power of the cylinder and the high-order aberrations. The final choice of CLs is based on their special features, the subsequent corneal changes and the patient’s needs.

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“…5 The aim of the current case report is to show a successful visual rehabilitation achieved with the fitting of a new-generation hybrid contact lens of reverse geometry in an irregular cornea after PKP, with an area of donor-host misalignment.…”

Section: 5005/jp-journals-10025-1054mentioning

confidence: 98%

Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty

Pérez-Cambrodí¹,

Ruiz-Fortes²

2013

International Journal of Keratoconus and Ectatic Corneal Diseases

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Purpose: To report the successful outcome obtained after fitting a new hybrid contact lens in a cornea with an area of donor-host misalignment and significant levels of irregular astigmatism after penetrating keratoplasty (PKP). Materials and methods:A 41-year-old female with bilateral asymmetric keratoconus underwent PKP in her left eye due to the advanced status of the disease. One year after surgery, the patient referred a poor visual acuity and quality in this eye. The fitting of different types of rigid gas permeable contact lenses was performed, but with an unsuccessful outcome due to contact lens stability problems and uncomfortable wear. Scheimpflug imaging evaluation revealed that a donor-host misalignment was present at the nasal area. Contact lens fitting with a reverse geometry hybrid contact lens (Clearkone, SynergEyes Carlsbad) was then fitted. Visual, refractive, and ocular aberrometric outcomes were evaluated during a 1-year period after the fitting.Results: Uncorrected distance visual acuity improved from a prefitting value of 20/200 to a best corrected postfitting value of 20/20. Prefitting manifest refraction was +5.00 sphere and -5.50 cylinder at 75º, with a corrected distance visual acuity of 20/30. Higher order root mean square (RMS) for a 5 mm pupil changed from a prefitting value of 6.83 µm to a postfitting value of 1.57 µm (5 mm pupil). The contact lens wearing was referred as comfortable, with no anterior segment alterations. Conclusion:The SynergEyes Clearkone contact lens seems to be another potentially useful option for the visual rehabilitation after PKP, especially in cases of donor-host misalignment.

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Contact Lens Visual Rehabilitation in Keratoconus and Corneal Keratoplasty

Cited by 21 publications

References 26 publications

Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

Visual management of aphakia with concomitant severe corneal irregularity by mini-scleral design contact lenses

Contact Lenses for Keratoconus- Current Practice

Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty

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