Fitting Tips and Visual Rehabilitation of Irregular Cornea with a New Design of Corneoscleral Contact Lens: Objective and Subjective Evaluation

Abstract

Objectives To study the fitting and the visual rehabilitation obtained with a corneoscleral contact lens, namely, Rose K2 XL in patients with irregular cornea. Methods This prospective study included 36 eyes of 36 patients with irregular cornea fitted with Rose K2 XL. Refractive and visual outcomes and mesopic and aberrometric parameters of fitted eyes were assessed at 2 weeks, 3 months, and 6 months after the initial lens use. Objective and subjective parameters of patient satisfaction and lens comfort were noted. Causes of lens discontinuation and complications were also recorded. Results Average logMAR VA improved significantly from 0.95 ± 0.09 without correction to 0.04 ± 0.05 six months after lens wear. Similarly, mesopic and aberrometric measures were significantly improved. Statistical analysis of the subjective patients' responses showed a significant acceptance of the lens by most of them. At the end of follow-up, the mean wearing time was 9.9 ± 2.9 hours per day. The most common cause of wearing discontinuation was persistent discomfort (16.7%) and high lens expenses(16.7%). Self-assessed questionnaire showed statistically significant improvement in nearly all measured subjective parameters. Conclusion Rose K2 XL lenses provide patients with irregular cornea with both quantitative and qualitative optimal visual function with high degree of patient comfort and satisfaction.

Mini-Scleral Contact Lens for Asian Eyes Post-Penetrating Keratoplasty with Smaller Palpebral Aperture: Case Reports

“…9 In addition, recently vision-related quality of life has also improved after wearing MSCL in keratoconus and irregular corneas. 3,9 Despite these advantages the most common reason for discontinuing scleral lens wear was due to insertion and removal difficulties. 1 This may be more pronounced in the Asian population, as anatomical differences for East Asian eyes include significantly smaller HVID, smaller palpebral apertures, and smaller corneas than white eyes.…”

“… 9 In addition, recently vision-related quality of life has also improved after wearing MSCL in keratoconus and irregular corneas. 3 , 9 …”

“…Numerous reports have shown the promising therapeutic potential of scleral lenses in keratoconus, 2 irregular corneas, 2 , 3 corneal ectasias, 4 and corneas post-PKP. 5 This study reports the use of a Onefit A 14.7 mm diameter MSCLs (Blanchard Contact Lenses, CooperVision, Lake Forest, California, USA) to improve vision in two patients with high corneal astigmatism after PKP.…”

Short-term visual outcome with sclerocorneal contact lens on irregular cornea

“…They provide significant improvement in visual acuity, high subjective comfort ratings, and prolonged usage times. [ 3 ] This is particularly important for patients with corneal irregularity when vision cannot be improved with rigid gas permeable lenses either because of the patient's poor tolerance level or inability to fit such a lens. The fluid reservoir between the lens and the ocular surface provides the moistening of the ocular surface.…”

Refractive Correction After Penetrating Keratoplasty by a New Soft Contact Lens with a Special Design for Astigmatism: A Case Report

“… 3 In cases such as these, it may be possible to wear a lens and correct visual acuity with a piggyback CL system, in which an HCL is worn on top of a SCL. 4 , 5 Examples of special CLs include scleral lenses, 6 hybrid lenses having a central rigid gas permeable portion bonded to the SCL, 7–13 and an SCL specially designed for irregular astigmatism. 14–16 …”