Whatever Happened to the Contact Lens as a Therapeutic Modality in Keratoconus?

2015 ◽  
Vol 09 (01) ◽  
pp. 19
Author(s):  
Ebru Toker ◽  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Contact Lens ◽  
Penetrating Keratoplasty ◽  
Contact Lenses ◽  
Therapeutic Modality ◽  
Treatment Modalities ◽  
Traditional Model ◽  
The Past ◽  
Functional Visual Acuity

Over the past decade the management of keratoconus has changed from the traditional model limited only to rigid gas permeable lenses or penetrating keratoplasty to an array of newer medical and surgical treatment modalities that focus on both prevention of disease progression and improvement of functional visual acuity. New design contact lenses such as keratoconus design rigid gas permeable lenses, soft lenses, hybrid and scleral lenses offer the advantage of better comfort together with improved vision. Fitting of these contemporary contact lenses may postpone or avoid the need for keratoplasty in most of the patients with keratoconus.

scholarly journals Preliminary Clinical Exploration of Scleral Lens Performance on Normal Eyes

2018 ◽  
Vol 2 (2) ◽  
pp. e14-e21
Author(s):  
Melissa Barnett ◽  
Jonathon Ross ◽  
Blythe Durbin-Johnson
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Healthy Subjects ◽  
Contact Lenses ◽  
Front Surface ◽  
Contact Lens Wear ◽  
Factors Associated ◽  
Rigid Contact ◽  
Lens Wear ◽  
Spectacle Correction

Abstract Objectives: The purpose of this study was to evaluate the performance (i.e. vision, comfort and fit) of spherical and front-surface toric scleral lenses in subjects with regular, healthy corneas. Methods: Scleral lenses were fitin the eyes (n = 16) of healthy subjects (n = 9) with regular corneas, absent of pathology, and studied using an observational, multi-visit design. Lens fit was objectively evaluatedby an experienced practitioner.Following 1 month of successful lens wear, participants completedsubjective satisfaction surveys regarding the scleral lens wearing experience. Results:  According to participant surveys, scleral lenses were subjectively preferred over soft toric or gas permeable contact lenses in 88% of eyes, including in all eyes fit with a front-surface toric scleral lens (n = 3). Seventy-five percent (75%) of eyes achieved visual acuity of 0.1 logMAR or better, while all eyes with prior spectacle wear achieved visual acuity with a scleral lens within 1 Snellen line of spectacle correction. Seventy-five percent (75%) of eyes achieved good subjective comfort with a scleral lens. No participants reported poor subjective vision and/or comfort. Conclusions:  Our findings suggest that subjects preferred the performance of a scleral lens (spherical or front-surface toric) compared to a soft toric or gas permeable contact lens. Moreover, scleral lenses may provide a viable, alternative contact lens modality option for patients considering discontinuation of traditional soft toric and/or rigid contact lens wear; so long as the factors associated with hypoxia remain minimized. Key Words:  scleral lens; scleral contact lens; front-surface toric scleral lens; lens performance; normal eyes; healthy eyes

scholarly journals Achondroplasia Associated with Bilateral Keratoconus

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Ammar M. Al Mahmood ◽  
Hind M. Al Katan ◽  
Ghada Y. Al Bin Ali ◽  
Samar A. Al-Swailem
Keyword(s):  
Visual Acuity ◽  
Rare Case ◽  
Penetrating Keratoplasty ◽  
Slit Lamp ◽  
Poor Vision ◽  
The Past ◽  
Uncorrected Visual Acuity ◽  
Hard Contact ◽  
Slit Lamp Biomicroscopy ◽  
Contact Lens Fitting

We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE). Right eye (RE) improved to 20/25. The patient underwent penetrating keratoplasty (PKP) in his LE. Twenty-seven months postoperatively, uncorrected visual acuity (UCVA) was 20/30. Ophthalmologists should be aware that patients with achondroplasia who complain of poor vision should be suspected of having keratoconus once other more common conditions are ruled out.

scholarly journals Parkinson's Disease Management: Towards a New Paradigm

1999 ◽  
Vol 26 (S2) ◽  
pp. S53-S57 ◽  
Author(s):  
Mark Guttman ◽  
Oksana Suchowersky
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Surgical Treatment ◽  
Disease Management ◽  
Management Strategy ◽  
Clinical Symptoms ◽  
Treatment Modalities ◽  
New Paradigm ◽  
The Past

Over the past decade, management of Parkinson's disease has changed significantly due to the expansion of medical and surgical treatment modalities. Neurologists now have the ability (and the challenge) of choosing from multiple medications to devise an individual management strategy for each patient depending on his/her clinical symptoms and needs. Several different surgical therapies are also available. The topics covered in this supplement have highlighted the new options that are now available, as well as the treatments that have been in clinical usage. This review attempts to synthesize the information that is currently available in an attempt to help clinical neurologists make the appropriate choice for their patients.

scholarly journals Clinical Performance of Toris K Contact Lens in Patients with Moderate to Advanced Keratoconus: A Real Life Retrospective Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ihsan Yilmaz ◽  
Ferah Ozcelik ◽  
Berna Basarir ◽  
Gokhan Demir ◽  
Gonul Durusoy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Clinical Performance ◽  
Real Life ◽  
Soft Contact Lenses ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Central Cone ◽  
The Mean

Objectives.To evaluate the visual performance of Toris K soft contact lenses in patients with moderate-to-advanced keratoconus and also to compare the results according to cone types, cone location, and severity of keratoconus.Materials and Methods.Sixty eyes of 40 participants were included in this retrospective study. Uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BCVA), best-contact lens corrected visual acuity (BCLCVA), and comfort rating via visual analogue scales (VAS) were measured.Results.The mean age was 27.3 ± 8.6 years (range: 18 to 54). The mean logMAR UCVA, BCVA, and BCLCVA were 0.85 ± 0.38 (range: 0.30–1.30), 0.47 ± 0.27 (range: 0.10–1.30), and 0.16 ± 0.20 (range: 0–1.00). There were significant increases in visual acuities with contact lenses (p<.05). BCLCVA was significantly better in oval type than globus type (p=.022). UCVA and BCLCVA were significantly better in moderate keratoconus group (p=.015,p=.018). The mean line gain in Snellen was 3.6 ± 1.8 lines (range: 0–7 lines). The mean line gain was higher in central cone group than paracentral cone group and oval group than globus group (p=.014,p=.045). The mean VAS score was 8.14 ± 1.88 (range: 6–10).Conclusions.Toris K can improve visual acuity of patients with keratoconus. Toris K is successful even in the moderate and advanced form of the disease.

scholarly journals Nonsurgical Procedures for Keratoconus Management

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
L. Rico-Del-Viejo ◽  
M. Garcia-Montero ◽  
J. L. Hernández-Verdejo ◽  
S. García-Lázaro ◽  
F. J. Gómez-Sanz ◽  
...  
Keyword(s):  
Contact Lens ◽  
Contact Lenses ◽  
Good Alternative ◽  
Lens System ◽  
Soft Contact ◽  
Visual Outcomes ◽  
Soft Contact Lenses ◽  
The Past ◽  
Contact Lens Fitting

Objectives. To describe the past 20 years’ correction modalities for keratoconus and their visual outcomes and possible complications.Methods. A review of the published literature related to the visual outcomes and possible complications in the context of keratoconus management using nonsurgical procedures for the last 20 years (glasses and contact lenses) was performed. Original articles that reported the outcome of any correction modalities of keratoconus management were reviewed.Results. The most nonsurgical procedure used on keratoconus management is the contact lens fitting. Soft contact lenses and soft toric contact lenses, rigid gas-permeable contact lenses, piggyback contact lens system, hybrid contact lenses, and scleral and corneoscleral contact lenses form the contemporary range of available lens types for keratoconus management with contact lenses. All of them try to restore the vision, improve the quality of life, and delay surgical procedures in patients with this disease. Complications are derived from the intolerance of using contact lens, and the use of each depends on keratoconus severity.Conclusions. In the context of nonsurgical procedures, the use of contact lenses for the management of keratoconic patients represents a good alternative to restore vision and improve the quality of live in this population.

scholarly journals DEJAVNIKI TVEGANJA ZA ZAPLETE PRI UPORABI KONTAKTNIH LEČ

2016 ◽  
Vol 85 (2) ◽  
Author(s):  
Mirna Štabuc Šilih
Keyword(s):  
Visual Acuity ◽  
Medical History ◽  
Contact Lens ◽  
Contact Lenses ◽  
Living Environment ◽  
Inappropriate Use ◽  
Everyday Work ◽  
And Storage

Contact lenses are freely available without professional examination and fitting, as well as without adequate introduction and instructions on handling, disinfection and storage. Contact lenses may have physiological, metabolic and anatomic effect on the eyes, which is manifested both on the eyelids, lacrimal film, conjunctiva and in all layers of the cornea - the epithelium, stroma and the endothelium. We can see these complications too often at our everyday work. The purpose of this paper is to draw attention to the potential complications due to inappropriate use of contact lenses.Contact lenses are otherwise a safe and effective method of correcting visual acuity; they are also useful for therapeutic purposes. Complications related to contact lenses wear could be largely avoided with an appropriate professional approach and the compliance of contact lens wearers. It is important to discuss with patients their medical history, their desires and expectations, their working and living environment; followed by professional examination of patients and appropriate fitting of contact lenses. Patients should receive detailed oral and written instructions and be subscribed to regular checks. But unfortunately, all this is not enough, if patients do not comply every day with given instructions.

scholarly journals Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty

2013 ◽  
Vol 2 (2) ◽  
pp. 69-72
Author(s):  
Rafael J Pérez-Cambrodí ◽  
Pedro Ruiz-Fortes
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Anterior Segment ◽  
Successful Outcome ◽  
Imaging Evaluation ◽  
Visual Rehabilitation ◽  
Distance Visual Acuity ◽  
Fitting In ◽  
Contact Lens Fitting

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.

scholarly journals A case report of visual outcome in keratoconus with retinitis pigmentosa

2018 ◽  
Author(s):  
Chiun-Ho Hou ◽  
Yun-Wen Chen ◽  
Ken-Kuo Lin ◽  
Jiahn-Shing Lee ◽  
Lai-Chu See ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Retinitis Pigmentosa ◽  
Contact Lens ◽  
Contact Lenses ◽  
Life Quality ◽  
Visual Outcome ◽  
Visual Aids ◽  
Blurred Vision ◽  
Visual Rehabilitation

Abstract Background: It is uncommon to see retinitis pigmentosa in keratoconus patients. The main difficulty of visual rehabilitation for this is restricted visual field. We presented the treatment and gene screen of visual system homeobox 1 (VSX 1) gene in this case. Case presentation: A 24-year-old man with retinitis pigmentosa presented with progressively blurred vision. Slit lamp examination revealed Vogt’s striae over both eyes, and corneal topography indicated bilateral keratoconus. We had tested 5 exons of VSX 1 gene from him and the did not find mutation on direct sequence. To improve visual acuity, we prescribed keratoconus rigid gas permeable (RGP) contact lens for him with good efficacy. However, lens dislocation occurred occasionally. He could not find dislocated lens easily due to visual field restriction, so he asked for more stable visual aids. Therefore, we instead prescribed scleral lens (SL), which were more stable on the ocular surface and led to more stable vision. Visual acuity was also gained with SL, but the tolerance time for SL was shorter compared to that of keratoconus RGP contact lens. To compare the efficacy of these two lenses, we surveyed life quality using the National Eye Institute Visual Functioning Questionnaire – 25 in three situations: baseline, with keratoconus RGP contact lens, and with SL. Conclusion: The patient used the two lens types according to his needs, and benefited from vision rehabilitation with both keratoconus RGP contact lens and SL. Keywords: keratoconus; retinitis pigmentosa; rigid gas permeable contact lenses; scleral lenses.

scholarly journals Comparison of the efficacy of lotrafilcon B and comfilcon A silicone hydrogel bandage contact lenses after transepithelial photorefractive keratectomy

2021 ◽  
Vol 10 (2) ◽  
pp. 43-49
Author(s):  
Nancy M. Lotfy ◽  
Tariq Alasbali ◽  
Abdulrahman M. Alsharif ◽  
Saeed M Al- Gehedan ◽  
Sabah Jastaneiah ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pain Score ◽  
Contact Lens ◽  
Contact Lenses ◽  
Corneal Thickness ◽  
Photorefractive Keratectomy ◽  
Epithelial Defect ◽  
Silicone Hydrogel ◽  
Corneal Epithelial Defect ◽  
Significant Difference

Background: At completion of transepithelial photorefractive keratectomy (t-PRK) surgery, the eye is usually fitted with a bandage contact lens to reduce discomfort and promote epithelial healing. This study aimed to compare the outcomes of eyes fitted with lotrafilcon B versus comfilcon A, silicone hydrogel bandage contact lenses after t-PRK for the correction of low to moderate myopia, with or without astigmatism. Methods: In this comparative, prospective study, patients with myopia < -6 D with or without astigmatism (< 1.75 D), who underwent t-PRK between January and June 2018, were randomly allocated to the lotrafilcon B and comfilcon A groups. Preoperative characteristics, including age, sex, eye treated, uncorrected visual acuity (UCVA), best-corrected visual acuity, mesopic pupil size, central corneal thickness, and refractive error were recorded. Postoperatively, pain score, UCVA, and corneal epithelial defect size on days 1, 4, and 7 were compared between the two groups. Results: Twenty-nine eyes were included in each group. Demographic characteristics and preoperative measurements were similar between the two groups. UCVA was significantly improved on day 7 as compared to day 1 in the comfilcon A group (P = 0.03), but remained the same in the lotrafilcon B group (P = 0.70) as on day 1 postoperatively. There was no significant difference in UCVA between the two groups at any follow-up visits (all P > 0.05). The pain score on the first postoperative day was significantly higher in the lotrafilcon B-fitted eyes than in the comfilcon A group (P < 0.001), but was significantly reduced in both groups compared to day 1 (both P < 0.001). The epithelial defect in the comfilcon A group was significantly greater than in the lotrafilcon B group (P < 0.001) at day 1 postoperatively, with significant improvement in both groups (both P < 0.001). Conclusions: Healing responses were better with lotrafilcon B than with comfilcon A bandage contact lenses. The patients had a greater mean pain score with lotrafilcon B than with comfilcon A lenses on the first postoperative day, yet the final outcome was comparable between the two groups. We did not encounter any postoperative complications related to contact lens wear. How to cite this article: Lotfy NM, Alasbali T, Alsharif AM, Al-Gehedan SM, Jastaneiah S, Al-Hazaimeh A, Ali H, Khandekar R. Comparison of the efficacy of lotrafilcon B and comfilcon A silicone hydrogel bandage contact lenses after transepithelial photorefractive keratectomy. Med Hypothesis Discov Innov Ophthalmol. 2021 Summer; 10(2): 1-7. https://doi.org/10.51329/mehdiophthal1420

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