Do visual performance and optical quality vary across different contact lens correction modalities in keratoconus?

Kumar, Preetam; Bandela, Praveen K.; Bharadwaj, Shrikant R.

doi:10.1016/j.clae.2020.03.009

Cited by 26 publications

(23 citation statements)

References 28 publications

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“…The baseline findings confirm the presence of a significant amount of HOAs in keratoconic eyes, while the use of a SL produced a marked reduction in RMS‐HOAs, coma, spherical aberration, secondary astigmatism and trefoil. This is consistent with several previous reports 6,12,15,34,35 6 .…”

Section: Discussionsupporting

confidence: 94%

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Fluid reservoir thickness and aberration relationship in keratoconic eyes with scleral lenses

Balakrishnan

Badrinarayanan

Sivaraman

et al. 2021

Ophthalmic Physiologic Optic

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Purpose To investigate the effect of varying the fluid reservoir (FR) thickness of scleral lenses (SL) on corrected distance visual acuity (CDVA), contrast sensitivity (CS) and higher‐order aberrations (HOAs) in keratoconic eyes. Methods Forty eyes with keratoconus were fitted with a diagnostic Boston Sight SL having three different FR thicknesses. CDVA, CS and HOAs were measured before and after 30 min of lens wear. An i‐Trace aberrometer and anterior segment optical coherence tomography (AS‐OCT) were used to measure HOAs and FR thickness, respectively. Results Statistically significant improvements in CDVA and CS were seen with different FR thickness lenses (p < 0.01). Baseline CDVA (0.22 ± 0.15) improved to 0.03 ± 0.06, 0.04 ± 0.07 and 0.07 ± 0.08 with low, standard and high FR lenses, respectively. Post‐hoc testing showed better CDVA with low (p = 0.006) and standard FR (p = 0.009) lenses compared to high FR lenses. Before lens wear, CS was 1.27 ± 0.27, which improved to 1.67 ± 0.11, 1.73 ± 0.12 and 1.66 ± 0.89 with low, standard and high FR lenses, respectively. Lenses with standard FR showed better CS compared with those having low (p = 0.009) and high FRs (p < 0.001). A statistically significant reduction of higher order‐root mean square aberrations (HO‐RMS), coma, spherical aberration, secondary astigmatism and trefoil were found with all FR thickness lenses compared to baseline (p < 0.01). No significant difference was noted between lenses (p = 0.01). All three lenses corrected almost equal amount of HOAs. A moderate positive correlation was observed between CDVA and HO‐RMS (r = 0.61, p < 0.001) for low FR lenses. Conclusions BostonSight SCLERALs were found to be very effective in improving vision, CS and reducing HOAs in keratoconus. Lenses with varying FR thickness showed equal effectiveness in visual performance and reducing HOAs. FR thickness should be considered an important factor to provide better vision and CS by minimising HOAs, as well as to maintain the normal physiology of eyes with keratoconus.

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Section: Discussionsupporting

confidence: 94%

“…reported a 71%–81% reduction of HOAs with semi‐scleral lenses and 49%–84% reduction with larger diameter SLs 34 in keratoconic eyes. In contrast, Kumar et al 35 . observed no difference between semi‐scleral and large‐scleras in all grades of keratoconus.…”

Section: Discussionmentioning

confidence: 81%

Fluid reservoir thickness and aberration relationship in keratoconic eyes with scleral lenses

Balakrishnan

Badrinarayanan

Sivaraman

et al. 2021

Ophthalmic Physiologic Optic

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“…Binocular resolution and stereoacuity also improve from spectacles to rigid corneal lenses in bilateral keratoconus [419]. Nonetheless, visual performance and optical quality do not appear to improve commensurately with the sophistication of contact lens design [420,421]. Furthermore, rigid corneal lens wear has been associated with a 2-fold increase in the risk of scarring; additionally, among rigid corneal lens wearers, the flatness of the fit was significantly associated with incident scarring [422,423].…”

Section: Keratoconusmentioning

confidence: 99%

“…In a prospective crossover study of rigid corneal, specialty rigid corneal, specialty soft and scleral contact lenses in a small number of subjects with early, moderate and advanced keratoconus, visual performance and optical quality did not improve commensurately with the sophistication of lens design across disease severity. The authors conclude that non-visual factors like quality of the lens fitting, wearing comfort and cost may therefore drive the selection of lens type in keratoconus more than the performance efficacy of these lenses [420].…”

Section: Keratoconusmentioning

confidence: 99%

BCLA CLEAR – Medical use of contact lenses

Jacobs

Carrasquillo²,

Cottrell

et al. 2021

Contact Lens and Anterior Eye

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The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for such applications. There is consistent evidence that bandage soft contact lenses, particularly silicone hydrogel lenses, improve epithelial healing and reduce pain in persistent epithelial defects, after trauma or surgery, and in corneal dystrophies. Drug delivery applications of contact lens hold promise for improving topical therapy. Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment. This report offers a practical and relevant summary of the current evidence for the medical use of contact lenses for all eye care professionals including optometrists, ophthalmologists, opticians, and orthoptists. Topics covered include indications for use in both acute and chronic conditions, lens selection, patient selection, wear and care regimens, and recommended aftercare schedules. Prevention, presentation, and management of complications of medical use are reviewed.

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“…The choice of CL often depends on the anatomical fit on the cornea/sclera, the comfort provided by the CL, the cost of the lens, and the visual performance. 5 …”

Section: Introductionmentioning

confidence: 99%

Keratoconus and Visual Performance with Different Contact Lenses

Marta¹,

Marques²,

Almeida³

et al. 2021

OPTH

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Purpose To analyze the visual performance in contact lens wearers with keratoconus. Methods A retrospective study including contact lens (CL) wearers was performed. The current best-corrected visual acuity with contact lens (BCVA-CL) and with spectacles (BCVA-S) correction, contrast sensitivity (CS) (by Metrovision-MonPack3 ® ), analysis of light scattering in the retina and vision break-up time (HD Analyzer ® ), and corneal tomography (Oculus Pentacam ® HR) were evaluated. Results This study included 96 eyes of 59 patients with Keratoconus. Rigid gas permeable contact lenses (RGPCL), hybrid contact lenses (HCL), and silicone hydrogel/hydrogel contact lenses (HGCL) were fitted in 67, 17, and 12 eyes, respectively. Dynamic objective scatter index (OSI) (p = 0.024), minimum OSI (p = 0.037) and maximum OSI (p = 0.040) were significantly better with RGPCL and worse with HGCL. Mean CS in photopic conditions was significantly worse with HGCL and better with HCL (p = 0.006), without differences in mesopic conditions (p = 0.121). RGPCL wearers showed a higher mean K (p = 0.020), and a lower corneal thickness at the thinnest point (p=0.011). Conclusion Visual quality varied significantly with different types of CL. Although RGPCL was fitted in patients with worse Pentacam tomographic parameters, RGPCL was associated with a better dynamic visual quality.

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Do visual performance and optical quality vary across different contact lens correction modalities in keratoconus?

Cited by 26 publications

References 28 publications

Fluid reservoir thickness and aberration relationship in keratoconic eyes with scleral lenses

Fluid reservoir thickness and aberration relationship in keratoconic eyes with scleral lenses

BCLA CLEAR – Medical use of contact lenses

Keratoconus and Visual Performance with Different Contact Lenses

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