Soft contact lens fitting after intrastromal corneal ring segment implantation to treat keratoconus |
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| Affiliation: | 1. Applied Vision Research Group, Faculty of Optics, Universidad Complutense de Madrid, 28037 Madrid, Spain;2. Hospital Clinico San Carlos, 28037 Madrid, Spain;1. University of Ulster, School of Biomedical Sciences, Coleraine, UK;2. Midland Eye Institute, Solihull, West Midlands, UK;3. Royal Centre for Defence Medicine, University Hospital, Birmingham, UK;4. Birmingham and Midland Eye Centre, Birmingham, UK;5. North London School of Ophthalmology, Queens Hospital, Essex Barking, Havering & Redbridge University Hospitals NHS Trust, UK;6. NIDEK Co. Ltd., Wendelstein, Germany;2. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, B.C;1. Clinical Research Center, School of Optometry, University of California, Berkeley, United States;2. Vision Science Graduate Program, University of California, Berkeley, United States;3. Chemical and Biomolecular Engineering Department, University of California, Berkeley, United States;1. Department of Chemical Engineering, University of Florida, PO Box 116005, Gainesville, FL 32611-6005, United States;2. College of Veterinary Medicine, University of Florida, PO Box 100101, Gainesville, FL 32610, United States |
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| Abstract: | PurposeTo assess the feasibility of fitting a lathed soft toric contact lens (STCL) after the implant of intrastromal corneal ring segments (ICRSs) to treat keratoconus.MethodsSix months after ICRS implantation, 47 eyes of 47 patients (18–45 years) were fitted with a STCL. In each eye, we determined refractive error, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and keratometry and asphericity measures. The outcome of STCL fitting was defined according to CDVA as successful (≤0.2 logMAR) or unsuccessful (>0.2 logMAR). Patients in the unsuccessful group were refitted with a piggy-back (PB) system. The above variables and the change in CDVA observed after STCL and PB lens fitting from spectacle CDVA were compared in the two groups.ResultsSTCL fitting was successful in 75%, 66.66% and 0% of the ICRS implanted eyes with stages I–III keratoconus, respectively. Spectacle-CDVA was 1.5 lines better and mean corneal power was 3.62D lower in the successful STCL group. In this group, the difference in cylinder axis between spectacles and STCL was 24.25° lower. PB refitting achieved a PB-CDVA ≤0.2 logMAR in all cases. A similar difference in the CDVA change achieved by contact lenses versus spectacles was observed in the successful STCL and PB refitted groups.ConclusionSTCL fitting is a feasible option in a large proportion of patients implanted with ICRS. When these lenses are unsatisfactory, a PB system is a good alternative. |
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| Keywords: | Keratoconus Intrastromal rings Soft toric contact lens Piggy back |
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