Optimization of contact lens fitting in keratectasia patients after laser in situ keratomileusis

2004 ◽  
Vol 30 (5) ◽  
pp. 1057-1066 ◽  
Author(s):  
Hyuk-Jin Choi ◽  
Mee-Kum Kim ◽  
Jae-Lim Lee
2006 ◽  
pp. 125-129
Author(s):  
Adamo Lui Netto ◽  
Jeffrey J. Walline

2019 ◽  
Vol 40 (1) ◽  
pp. 213-225 ◽  
Author(s):  
Jihong Zhou ◽  
Wei Gu ◽  
Shaowei Li ◽  
Lijuan Wu ◽  
Yan Gao ◽  
...  

Abstract Purpose To investigate the predictive factors of postoperative myopic regression among subjects who have undergone laser-assisted subepithelial keratomileusis (LASEK), laser-assisted in situ keratomileusis (LASIK) flap created with a mechanical microkeratome (MM), and LASIK flap created with a femtosecond laser (FS). All recruited patients had a manifest spherical equivalence (SE) from − 6.0D to − 10.0D myopia. Methods This retrospective, observational case series study analyzed outcomes of refraction at 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Predictors affecting myopic regression and other covariates were estimated with the Cox proportional hazards model for the three types of surgeries. Results The study enrolled 496 eyes in the LASEK group, 1054 eyes in the FS-LASIK group, and 910 eyes in the MM-LASIK group. At 12 months, from − 6.0D to − 10.0D myopia showed that the survival rates (no myopic regression) were 52.19%, 59.12%, and 58.79% in the MM-LASIK, FS-LASIK, and LASEK groups, respectively. Risk factors for myopic regression included thicker postoperative central corneal thickness (P ≦ 0.01), older age (P ≦ 0.01), aspherical ablation (P = 0.02), and larger transitional zone (TZ) (P = 0.03). Steeper corneal curvature (Kmax) (P = 0.01), thicker preoperative central corneal thickness (P < 0.01), smaller preoperative myopia (P < 0.01), longer duration of myopia (P = 0.02), with contact lens (P < 0.01), and larger optical zone (OZ) (P = 0.02) were protective factors. Among the three groups, the MM-LASIK had the highest risk of postoperative myopic regression (P < 0.01). Conclusions The MM-LASIK group experienced the highest myopic regression, followed by the FS-LASIK and LASEK groups. Older age, aspheric ablation used, thicker postoperative central corneal thickness, and enlarging TZ contribute to myopic regression; steeper preoperative corneal curvature (Kmax), longer duration of myopia, with contact lens, thicker preoperative central corneal thickness, lower manifest refraction SE, and enlarging OZ prevent postoperative myopic regression in myopia from − 6.0D to − 10.0D.


Author(s):  
Roberto Soto-Negro

ABSTRACT We report the case of a 35-year-old woman diagnosed with keratoconus since she was 18 years old and wearer of corneal rigid contact lenses (CLs). We refitted the case with the fully scleral CL ICD16.5 (Paragon Vision Sciences) for obtaining not only a successful visual restoration, but also a comfortable wear. We initiated the fitting with the spherical model of the CL, but it failed due to instability of the lens. We confirmed the presence of a clear asymmetry in the anterior scleral geometry in both eyes by using the profilometer eye surface profiler (ESP, Eaglet Eye), with a difference between nasal and temporal sagittal heights of 470 and 170 μm in right and left eyes respectively. Although this profile suggested the need for the fitting of a CL with significant peripheral toricity, we followed the manufacturer's guidelines and performed a trial with a CL of moderate peripheral toricity (125 μm of difference between steep and flat meridian). The stability of the CL failed again and finally a CL with a peripheral toricity close to that measured with the profilometer was fitted. With this lens, good visual performance, lens stability, and comfort was obtained and maintained during a 1-year follow-up. This case suggests that fully scleral CLs fitting might be optimized with the use of corneo-scleral profilometers, minimizing potentially the number of trials. This potential benefit should be investigated further in future studies. How to cite this article Piñero DP, Soto-Negro R. Anterior Eye Profilometry-guided Scleral Contact Lens Fitting in Keratoconus. Int J Kerat Ect Cor Dis 2017;6(2):97-100.


Author(s):  
Rafael J Pérez-Cambrodí ◽  
Pedro Ruiz-Fortes

ABSTRACT Purpose To report the successful outcome obtained after fitting a new hybrid contact lens in a cornea with an area of donor-host misalignment and significant levels of irregular astigmatism after penetrating keratoplasty (PKP). Materials and methods A 41-year-old female with bilateral asymmetric keratoconus underwent PKP in her left eye due to the advanced status of the disease. One year after surgery, the patient referred a poor visual acuity and quality in this eye. The fitting of different types of rigid gas permeable contact lenses was performed, but with an unsuccessful outcome due to contact lens stability problems and uncomfortable wear. Scheimpflug imaging evaluation revealed that a donor-host misalignment was present at the nasal area. Contact lens fitting with a reverse geometry hybrid contact lens (Clearkone, SynergEyes Carlsbad) was then fitted. Visual, refractive, and ocular aberrometric outcomes were evaluated during a 1-year period after the fitting. Results Uncorrected distance visual acuity improved from a prefitting value of 20/200 to a best corrected postfitting value of 20/20. Prefitting manifest refraction was +5.00 sphere and .5.50 cylinder at 75°, with a corrected distance visual acuity of 20/30. Higher order root mean square (RMS) for a 5 mm pupil changed from a prefitting value of 6.83 μm to a postfitting value of 1.57 μm (5 mm pupil). The contact lens wearing was referred as comfortable, with no anterior segment alterations. Conclusion The SynergEyes Clearkone contact lens seems to be another potentially useful option for the visual rehabilitation after PKP, especially in cases of donor-host misalignment. How to cite this article Pérez-Cambrodí RJ, Ruiz-Fortes P, Llorens DPP. Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty. Int J Kerat Ect Cor Dis 2013;2(2):69-72.


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