Silicone Hydrogel Miniscleral Contact Lenses after Corneal Collagen Crosslinking for Post-LASIK Keratoectasia

Abstract

Purpose: To report successful visual rehabilitation of post refractive surgery keratoectasia shortly after corneal collage crosslinking (CXL) procedure achieved with silicone hydrogel mini-scleral (SHmS) contact lens. Materials and methods:A 29-year-old woman attended to our clinic with complaints on decreased vision in her left eye. Twelve years earlier she underwent bilateral laser-assisted in situ keratomileusis (LASIK) procedure for myopia correction. Corneal topography revealed bilateral central keratoectasia with maximal keratometry values of 55.4 Diopter (D) for her right eye and 59.7 D for the left, corneal thicknesses were 422 and 443 respectively. The patient underwent an uneventful CXL procedure in her left eye and was fitted with SHmS lens 5 weeks later. The lens was designed to rest over the patients' sclera and perilimbal cornea and vault the central cornea with minimal support over it.Results: SHmS lens fitting resulted in significant subjective improvement in visual acuity (from 20/200, unaided to 20/25, contact lens corrected). The patient was able to wear the lens upto 10 hours a day with stable contact lens corrected vision. No contact lens related complications, such as edema or neovascularization were observed during 3 months follow-up period. As a result of successful restoration of vision in the CXL-treated eye, the patient was scheduled for the procedure in her other eye.Conclusion: SHmS contact lens should be considered as an option for the visual rehabilitation of corneas shortly after collagen corneal crosslinking procedure. This novel contact lens modality made from flexible and highly gas permeable material minimizes contact lens influence on corneal recovery after CXL and provides an excellent visual outcome.