Possibilities of scleral lenses for visual rehabilitation of patients with corneal scars

2021 ◽  
pp. 157-161
Author(s):  
O.I. Ryabenko ◽  
◽  
O.M. Selina ◽  
E.M. Tananakina ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Efficacy And Safety ◽  
Visual Rehabilitation ◽  
Optical Correction ◽  
Vision Correction ◽  
Post Traumatic ◽  
Key Words Cornea ◽  
Irregular Astigmatism ◽  
Spectacle Correction

Purpose. To analyze the efficacy and safety of SCL in patients with corneal cicatricial changes and other concomitant conditions. Material and мethods. The study included 19 patients (20 eyes) with cicatricial deformity of the cornea of various etiology, who were fitted with scleral contact lenses. Results and discussions. The use of SCL is possible in post-traumatic pathology, such as corneoscleral scars with or without aphakia, as well as after keratitis with an outcome in cicatricial deformity, cicatricial changes after a burn. A significant increase in visual acuity compared with spectacle correction has been proven. Depending on the topography of the scar, it is possible to select scleral lenses such as Oblate and Prolate, as well as with different versions of the support zone: both toric and quadratic. Conclusion. Scleral lenses can be successfully used for optical correction in patients with cicatricial changes in the cornea and other concomitant post-traumatic conditions of ineffectiveness of other methods of visual rehabilitation. Key words: cornea, lenses, vision correction, contact lenses, visual rehabilitation, scleral lenses, corneal scars, post-traumatic astigmatism, aphakia, keratitis, toric lenses, quadratic lenses, astigmatism, irregular cornea, regular cornea, regular astigmatism, irregular cornea, irregular astigmatism, prolate, oblate.

scholarly journals Visual rehabilitation of patients with irregular cornea

The Eye ◽  
2019 ◽  
Vol 125 (2019-1) ◽  
pp. 26-32 ◽  
Author(s):  
Alexander Myagkov ◽  
Elena Belousova ◽  
Natalya Ignatova ◽  
Oksana Petrova
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Visual Comfort ◽  
Irregular Surface ◽  
Visual Rehabilitation ◽  
Main Method ◽  
Landing Zone ◽  
Optical Correction ◽  
Selection Of ◽  
Spectacle Correction

Purpose: To estimate the possibility of optical correction of an irregular surface of a cornea at primary ectasia (keratoconus) and secondary ectasia (a consequence of radial keratotomy (RKT) and Keratoplasty) for improvement of the maximum of visual acuity. Material and methods: In the study the scleral gas-permeable lenses (SGCL) were fitting by the 60 patients, it was 45 men and 15 women from them. The 46 patients had various stage of keratoconus and 14 patients had the keratectasia after RKT. On the 5 eyes of the patients was carried out keratoplasty earlier. Criteria of successful selection of SGCL considered achievement of steadily high visual acuity, comfort of carrying and the optimal clearance in apical zone, in the limbal and landing zone on the conjunctiva also. The results: In the course of the study, the maximum visual acuity in all patients was achieved with mini-SGKL correction irrespective of type of keratoektasia. All patients observed visual comfort compared with spectacle correction or correction with other types of contact lenses. Conclusion: Scleral gas-permeable contact lenses are the main method of correction at patients with irregular corneas and provide the best visual acuity.

scholarly journals Visual Acuity in Myopes with Standard and Reversed Contrast Optotypes

2017 ◽  
Vol 71 (1-2) ◽  
pp. 22-26
Author(s):  
Gatis Ikaunieks ◽  
Anete Petrova ◽  
Karola Panke ◽  
Gunta Krūmiņa
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Optical Correction ◽  
Optical Defocus ◽  
Spectacle Correction ◽  
Low Order

Abstract The aim of this study was to assess the visual acuity of myopes with standard and reversed contrast optotypes and to determine how the visual acuity of myopes is affected by optical defocus and the type of optical correction, either contact lenses or spectacles. Twenty-three myopic subjects (18 and 23 years old) with uncorrected vision had their visual acuity assessed with both standard and reversed contrast optotypes. The study also included 10 myopes with contact lens as well as habitual spectacle correction. The visual acuity for myopes with uncorrected vision was better with reversed than standard contrast optotypes. Better reversed contrast than standard contrast visual acuity was obtained also with spectacle and contact lens correction. This result could be due in part to low order aberrations (optical defocus) in myopes spectacle or contact lenses correction.

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 REHABILITATION POSSIBILITIES OF SOFT CONTACT CORRECTION IN POST-TRAUMATIC AND CONGENITAL PATHOLOGY OF CHILDREN

2018 ◽  
Vol 13 (4) ◽  
pp. 162-166
Author(s):  
V. V Neroev ◽  
E. N Verigo ◽  
Olga M. Selina
Keyword(s):  
Congenital Abnormalities ◽  
Contact Lenses ◽  
Soft Contact ◽  
Number Of Children ◽  
Soft Contact Lenses ◽  
Full Development ◽  
Post Traumatic ◽  
Different Diameters ◽  
Transparent Contact ◽  
Spectacle Correction

Objective. To analyze the results of the use of contact correction in the rehabilitation of children with post-traumatic and congenital abnormalities. Material and methods. 424 patients, aged between 3 months and 17 years, using soft contact lenses using traditional and special methods of examination. Results and discussion. It was established that in the overwhelming number of children who were assigned to wear, the post-traumatic pathology prevailed - 341 (79.1%) patients; congenital abnormality was 83 cases (20.9%). Contact lenses were made individually according to the developed technologies from a hydrogel material by turning using biocompatible paint, which allows combining several color zones of different diameters, while achieving optimal functional and cosmetic results. Proved a significant increase in visual acuity compared with spectacle correction and correction of transparent contact lenses in 86.4% of children. Thus, the use of soft contact lenses, performing corrective, diaphragmatic and cosmetic function is a method of preventing the development of amblyopia, strabismus, contributing to the full development of the visual analyzer in children.

scholarly journals Simultaneous Topography-guided Surface Ablation with Collagen Cross-linking for Keratoconus

2016 ◽  
Vol 5 (2) ◽  
pp. 71-76
Author(s):  
Igor Kaiserman ◽  
Lily Karmona ◽  
Tzahi Sela ◽  
Oz Franco ◽  
Avi Shoshani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Cross Linking ◽  
Visual Rehabilitation ◽  
Surface Ablation ◽  
Uncorrected Visual Acuity ◽  
Promising Treatment ◽  
Functional Vision ◽  
Collagen Cross Linking

ABSTRACT Purpose In this article, we present the results of eight eyes of patients who underwent combined same-day partial topography-guided surface ablation followed by accelerated collagen cross-linking (CXL) procedure at Care-Vision Laser Centers to achieve stabilization of corneal ectasia and enhance visual rehabilitation in keratoconus. Materials and methods A retrospective nonrandomized review of 8 eyes of 6 patients who underwent the Athens Protocol for progressive keratoconus. Each patient underwent topography-guided ablation followed by CXL procedure. Follow-up Follow-up was done on day 1, day 7, and then at 1, 3, 6, and 12 months. Results There was a rapid and significant improvement in uncorrected visual acuity and best-corrected visual acuity in 100% eyes, a reduction of keratometric values, and symmetry between vertical hemimeridians. Topographic evaluation showed a marked improvement in irregularity. There were no signs of keratoconic progression noted in any of the eyes on last follow-up. No adverse events were reported in any patient. Conclusion Simultaneous surface ablation + CXL seems to be a promising treatment capable of offering patients functional vision and halting progression of the disorder. Precis Simultaneous topography-guided custom ablation treatment and photorefractive keratectomy with CXL offers keratoconic patients intolerant to contact lenses both stabilization of the cornea and improved functional vision with spectacles correction. How to cite this article Karmona L, Sela T, Franco O, Shoshani A, Munzer G, Kaiserman I. Simultaneous Topography-guided Surface Ablation with Collagen Cross-linking for Keratoconus. Int J Kerat Ect Cor Dis 2016;5(2):71-76.

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.

Use of new-generation hybrid contact lenses for managing challenging corneas

2020 ◽  
pp. 112067212094275
Author(s):  
Ibrahim Inan Harbiyeli ◽  
Elif Erdem ◽  
Puren Isik ◽  
Meltem Yagmur ◽  
Reha Ersoz
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Contact Lenses ◽  
Corrected Visual Acuity ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Mean ◽  
New Generation ◽  
Generation Hybrid ◽  
Irregular Astigmatism

Introduction: To evaluate the safety and efficacy of new-generation hybrid contact lenses (HCL) among patients with irregular astigmatism. Methods: Medical records of 25 patients fit with new-generation HCL (Eyebrid® and AirFlex®) were retrospectively reviewed. The data collected included etiology of irregular astigmatism, uncorrected visual acuity, manifest refraction, spectacle-corrected visual acuity (S-CDVA), steep / flat keratometric values, corneal astigmatism, records of rigid / soft CL fitted before HCL, all parameters of the trial lenses, and the final prescribed HCL parameters and HCL-CDVA. Results: The study included 34 eyes from 25 patients (nine females and 16 males) with an average age of 29 ± 13 (ranging from 8–56) years. In total, 25 eyes with keratoconus, four with post - keratoplasty astigmatism, three with irregular astigmatism due to corneal trauma and two with residual astigmatism after radial keratotomy were fit with HCL. The mean S-CDVA (logMAR) improved significantly from 0.76 ± 0.41 to 0.14 ± 0.15 with HCL ( p < 0.01). The most common indication for HCL was inability to fit with rigid gas permeable (RGP) lenses (22 eyes). The average number of lenses to successful fit was 1.4 (mode, 1; median, 1) and ideal fit was achieved with the first trial lens in 25 eyes (73%). Seven patients (nine eyes, 36%) discontinued lens use within the first 6 months because of discomfort (six eyes, 24%), ocular allergy (two eyes, 8%) and tearing of contact lens (one eye, 4%). Discussion: New-generation HCL may be a suitable option for fitting challenging corneas with irregular astigmatism that cannot be rehabilitated efficiently with rigid lenses.

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 “OKVision OKV-SL” customizable soft contact lenses fitting guide

The Eye ◽  
2020 ◽  
Vol 22 (4(132)) ◽  
pp. 61-68
Author(s):  
A. V. Myagkov ◽  
Zh. N. Poskrebysheva
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Soft Contact ◽  
Soft Contact Lenses ◽  
Vision Correction

The purpose of this guide is to introduce ophthalmologists and optometrists to the basics of fitting of customizable soft contact lenses, which is an important knowledge that enhances practitioners’ skills and helps provide a high visual acuity for many patients.Material and methods. This guide sets forth the principles of calculation of contact lens parameters, defines parameters specific to customizable lenses as well as assessment of the fit and the rules of lens handling and care.Conclusions. Following the fitting guide ensures a successful vision correction with customizable soft contact lenses for both doctor and the patient.

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