Fitting an MSD (Mini Scleral Design) rigid contact lens in advanced keratoconus with INTACS

Dalton, Kristine; Sorbara, Luigina

doi:10.1016/j.clae.2011.05.001

Cited by 40 publications

(22 citation statements)

References 32 publications

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“…[1516173031] There is only one case report of MSD contact lens fitting in advanced keratoconus with INTACS. Recently, Dalton and Sorbara described one patient with keratoconus who was successfully fitted with a mini scleral contact lens for residual refractive error after ICRS surgery.…”

Section: Discussionmentioning

confidence: 99%

Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Alipour

Rahimi

Hashemian

et al. 2016

J Ophthalmic Vis Res

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Purpose:To evaluate the feasibility and efficacy of mini-scleral design (MSD) contact lenses to treat keratoconus patients who were unsatisfied with the results of corneal inlay.Methods:In this prospective interventional case series, 9 eyes of 6 keratoconus patients who were unsatisfied with the results of corneal inlay were fitted with MSD contact lenses. Demographic data, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and higher order aberrations (HOAs) were evaluated before contact lens fitting. Corrected visual acuity by placing the MSD contact lens with or without over-refraction, and HOAs were measured one hour after contact lens fitting. One month after contact lens wearing, corrected visual acuity by placing the MSD contact lens with over-refraction and possible contact lens related problems were assessed. Ocular comfort and contact lens handling problems were asked in follow-up visits. The data was analyzed using descriptive statistical tests.Results:Nine eyes of 6 patients were successfully fitted with the mini-scleral lens. Fitting was ideal in 7 eyes and acceptable in 2 eyes. Mean corrected visual acuity by placing the MSD lens without over-refraction was 0.09 (range, 0.00-0.15) LogMAR which was significantly better than the mean BSCVA of 0.38 (range, 0.2-0.6) LogMAR (P = 0.007). The mean root mean square (RMS) of third-order coma and trefoil significantly decreased after MSD contact lens fitting (P = 0.012 and P = 0.015, respectively); however, changes in the fourth-order spherical aberration were not statistically significant (P = 0.336).Conclusion:Mini-scleral contact lenses may be helpful in the management of visually unsatisfied patients after corneal inlay.

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Section: Discussionmentioning

confidence: 99%

Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Alipour

Rahimi

Hashemian

et al. 2016

J Ophthalmic Vis Res

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“…20 As the severity of KC increases, CL fitting becomes more complex, and special designs to match the altered corneal shape may be required. In case of corneal GP lens failure due to disease severity or corneal GP lens intolerance, other options such as piggyback lenses (corneal GP lens fitted over a soft lens), 21 hybrid lenses (lens with a central GP portion and a soft skirt in the periphery), 22-25 scleral lenses, [26][27][28] or miniscleral lenses [29][30][31] are available. Popularity of scleral lenses for the correction of irregular corneas has increased in the recent years with the advent of better materials and designs.…”

Section: Contact Lensesmentioning

confidence: 99%

“…43 Piggyback lenses, hybrid lenses, scleral lenses, and mini scleral lenses have a role when corneal GP lenses have failed. [21][22][23][24][25][26][27][28][29][30][31]38,47 Piggyback lenses provided better vision, comfort, and corneal health. 21 In corneal GP lens-intolerant KC eyes, piggyback lenses worn for an average period of 6 months showed improvement in the tolerance level of corneal GP lenses.…”

Section: Contact Lensesmentioning

confidence: 99%

“…The lenses provided vision comparable to corneal GP lenses and better comfort and vision-related QOL. [22][23][24][25] Similarly mini scleral [26][27][28] and scleral lenses 29-31 provide better vision and comfort in moderate to severe KC when other CL designs fail to fit. Although the comfort level with different types of CLs is different, no difference in the vision-related QOL has been reported with different types of CLs.…”

Section: Contact Lensesmentioning

confidence: 99%

See 1 more Smart Citation

Outcome of Keratoconus Management: Review of the Past 20 Years' Contemporary Treatment Modalities

Mandathara

Stapleton

Willcox

2017

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…10 Scleral contact lenses are large rigid gas permeable contact lenses of diameter of up to 23,11 which rest on the sclera of the eye and cover the cornea of the eye like a dome lid. 12 Scleral lenses create a tear film between the back surface of the lens and the front surface of the cornea, thereby compensating for the aberrations in the cornea. 13 On insertion of the scleral contact lenses, air bubbles may occasionally get trapped behind the lens, 7,14,15 which may cause discomfort, visual disturbances and even small dry spots on the corneal surface.…”

Section: 5005/jp-journals-10025-1040mentioning

confidence: 99%

A Prospective Clinical Evaluation of a New Scleral Contact Lens for Patients with Distorted Corneas

Fine¹,

Gordon‐Shaag²,

Leibowitz³

et al. 2013

International Journal of Keratoconus and Ectatic Corneal Diseases

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Objectives: A prospective clinical evaluation of the physiological fit and visual performance of a novel commercially available rigid gas permeable (RGP) scleral contact lens in subjects suffering from distorted corneas is described. Materials and methods:The physiological fit and visual performance of 23.5 mm and 21 mm RGP scleral contact lenses were assessed in 14 subjects (22 eyes) and nine subjects (12 eyes), respectively. All but one participant with a distorted cornea as a result of an infection, suffered from varying grades of keratoconus. In a subset of seven subjects (8 eyes), the higher order aberrations were measured with and without the scleral lenses. Results:The 23 mm RGP scleral lens improved visual performance in 82% of the participants and eight subjects were satisfied with the lenses. The 21 mm lens improved visual performance in 83% of the participants, and four subjects were satisfied with the lenses. Subjects that were satisfied with the lenses tended to lack other forms of visual correction. In the seven subjects that were included in the substudy, the total lower order, higher order, coma, and tetrafoil root mean square were significantly reduced (p df=7 < 0.05) with the scleral contact lenses, whereas the total trefoil was not. Conclusion:RGP scleral lenses can be comfortably worn for approximately 7 hours, improve visual acuity, and reduce higher order wavefront aberrations. The lenses can be fit easily by the practitioner, though a trial lens set is necessary. The lenses are recommended in cases where other forms of visual correction can no longer be tolerated and as a long-term or temporary alternative to corneal transplant.

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Fitting an MSD (Mini Scleral Design) rigid contact lens in advanced keratoconus with INTACS

Cited by 40 publications

References 32 publications

Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Outcome of Keratoconus Management: Review of the Past 20 Years' Contemporary Treatment Modalities

A Prospective Clinical Evaluation of a New Scleral Contact Lens for Patients with Distorted Corneas

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