Corneal Thinning after Contact Lens-related Infective Keratitis

ABSTRACT Purpose To describe two cases of contact lens-related infectious keratitis with secondary corneal thinning. Material and methods Case reports and review of the literature. Results The first case is of a 13-year-old girl, contact lens user, admitted for acute corneal infection in her right eye (OD). Seven years after treatment, she presented with corneal thinning and flattening with uncorrected distance visual acuity of 20/30 OD; thinnest value was 363 µm in OD and 513 µm in the left eye (OS). The second case is a 22-year-old male, cosmetic contact lens user, first presented with severe keratitis in OD. One year after treatment, the eye was quiet with moderate corneal opacity; corneal thickness was 228 µm OD and 561 µm OS. Ectasia was identified due to the protrusion and steepening with an irregular curvature pattern. Rigid gas permeable (RGP) contact lens fitting enabled visual acuity of 20/25 OD. Conclusion Corneal melt with secondary stromal loss and thinning may lead or not to secondary ectasia. Visual rehabilitation is possible with RGP contact lenses despite corneal opacity. The risk of infectious keratitis among contact lenses users should be considered. How to cite this article Almeida R, Rodrigues F, Santos M, Siqueira R, Contarini P, Salgado-Borges J, Ambrosio R Jr. Corneal Thinning after Contact Lens-related Infective Keratitis. Int J Kerat Ect Cor Dis 2014;3(2):95-98.

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

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1054 ◽

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.

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A case report of visual outcome in keratoconus with retinitis pigmentosa

10.21203/rs.1.6/v1 ◽

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.

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

Medical hypothesis discovery and innovation in ophthalmology ◽

10.51329/mehdiophthal1420 ◽

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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Fitting of a New Design of Full Scleral Contact Lens in Advanced Keratoconus with Previous Implantation of Intracorneal Ring Segments

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1099 ◽

2015 ◽

Vol 4 (2) ◽

pp. 56-59

Keyword(s):

Visual Acuity ◽

Contact Lens ◽

Optical Power ◽

Visual Quality ◽

Limited Effect ◽

Visual Rehabilitation ◽

Ring Segment ◽

Intracorneal Ring Segment ◽

Topographic Pattern ◽

Corneal Thinning

ABSTRACT This case report reports the visual rehabilitation obtained with the fitting of a new design of full scleral contact lens (ICD 16.5 contact lens, Paragon Vision Sciences, distributed by Lenticon, Madrid, Spain) in a cornea with advanced keratoconus and previous implantation of intracorneal ring segment with a very limited effect. This eye had a refraction of −3.00 × 55° cylinder, providing a visual acuity of 0.5 LogMAR. The topographic pattern was very irregular with the presence of a significant central protrusion and a significant central corneal thinning. Some previous unsuccessful fittings have been performed with corneal and corneal-scleral lenses. A comfortable wearing was achieved with a fully scleral contact lens of 4600 µm of sagittal height, optical power of −11.25 D, and providing an apical clearance of 196 µm. A visual acuity of 0.0 LogMAR combined with a relevant aberrometric improvement was achieved with this contact lens. The patient was completely satisfied with the fitting. The result was maintained during 1 year after the fitting. Full scleral lenses are then able to provide comfortable wear and a significant increase in visual acuity combined with a significant improvement in the visual quality in eyes with advanced keratoconus. How to cite this article Llorens DPP. Fitting of a New Design of Full Scleral Contact Lens in Advanced Keratoconus with Previous Implantation of Intracorneal Ring Segments. Int J Kerat Ect Cor Dis 2015;4(2):56-59.

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Transepithelial Photorefractive Keratectomy with Crosslinking for Keratoconus

The Open Ophthalmology Journal ◽

10.2174/1874364101307010063 ◽

2013 ◽

Vol 7 (1) ◽

pp. 63-68 ◽

Cited By ~ 8

Author(s):

Achyut N Mukherjee ◽

Vasilis Selimis ◽

Ioannis Aslanides

Keyword(s):

Contact Lens ◽

Contact Lenses ◽

Corneal Thickness ◽

Single Step ◽

Photorefractive Keratectomy ◽

Spherical Equivalent ◽

Visual Rehabilitation ◽

Postoperative Assessment ◽

Ethical Approval

Purpose: To analyse visual, refractive and topographic outcomes of combining transepithelial photorefractive keratectomy (tPRK) with simultaneous corneal crosslinking for the visual rehabilitation of contact lens intolerant keratoconus patients. Methods: Patients with topographically significant keratoconus, limited corrected vision and intolerant of contact lenses were prospectively recruited, subject to ethical approval and consent. All patients underwent single step aspheric tPRK and sequential crosslinking. Preoperative vision, refraction, corneal topography and wavefront were assessed, with postoperative assessment at 1, 3, 6, and 12 months. Results: 22 eyes of 14 patients were included in the pilot study. Mean age was 32 years (SD 6.8, range 24 to 43). Mean preoperative unaided vision was 1.39 LogMAR (SD 0.5) best corrected 0.31 LogMAR (SD 0.2). Mean preoperative spherical equivalent was -2.74 Diopters (D) (SD 4.1 range -12.25 to +7.75), and mean cylinder -2.9 D (SD 1.2, range 0 to -5.5). Mean central corneal thickness was 461um (SD 29, range 411 to 516). Vision improved postoperatively; unaided 0.32 LogMAR (SD 0.4), best corrected 0.11 (SD 0.13) (P=<0.005). Mean postoperative cylinder was -1.4D (SD1.2), significantly reduced (p<0.005). Maximum keratometry (Kmax) was stable throughout postoperative follow up. (p<0.05). Conclusions: Non topographic transepithelial PRK with simultaneous crosslinking improves vision, and may offer an alternative to keratoplasty in contact lens intolerant keratoconus. Further comparative studies to topographic PRK techniques are indicated.

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

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-5-157-161 ◽

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.

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Preliminary Clinical Exploration of Scleral Lens Performance on Normal Eyes

Journal of Contact lens Research and Science ◽

10.22374/jclrs.v2i2.32 ◽

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

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Visual rehabilitation of patients with irregular cornea

The Eye ◽

10.33791/2222-4408-2019-1-26-32 ◽

2019 ◽

Vol 125 (2019-1) ◽

pp. 26-32 ◽

Cited By ~ 1

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.

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Awareness of Contact Lens Related Ocular Complications among Opticians of Lahore

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i4.1262 ◽

2021 ◽

Vol 37 (4) ◽

Author(s):

Ahmed Sohail ◽

Zain Ul Abideen ◽

Fatima Zahid ◽

Wahid Bakhsh

Keyword(s):

Contact Lens ◽

Contact Lenses ◽

Corneal Opacity ◽

Acanthamoeba Keratitis ◽

Bacterial Keratitis ◽

Age Group ◽

Cross Sectional Survey ◽

Ocular Complications ◽

Cross Sectional ◽

One Year

Purpose: To determine the awareness regarding contact lens related ocular complications among opticians of Lahore and to find out the relationship between the awareness and their educational qualification. Study Design: Cross sectional survey. Place and duration of Study: University of Lahore from April 2020- December 2020. Methods: This survey included opticians of different areas of Lahore, Pakistan. Two hundred and eleven opticians responded to a pre-tested, structured close ended questionnaire. Data comprised of demographics and contact lens selling experience. Information regarding awareness about contact lens related complications was also sought. The data were analyzed using SPSS 25.0. Results: A total of 211 opticians participated in the survey. All subjects were males. Fifty four (25.6%) subjects were from the age group of 15 to 30 years, 122 (57.8%) were from the age group of 31 to 45 and 35 (16.6%) were from the age group of 46 to 60 years. Only 4.7% had contact lens dispensing diploma. Thirty seven percent patients had contact lens selling experience of 2 to 10 years. Similar percentage had more than 10 years of experience. Ten percent had less than one year of experience. Only 54 participants out of 211 had knowledge about dry eye, 9 knew about Acanthamoeba keratitis and Bacterial keratitis and only 2 were aware of corneal opacity. Conclusion: Majority of the opticians of Lahore are unaware of the contact lenses related complications. Sale of cosmetic lenses for fashion purpose should be discouraged and banned if not prescribed by optometrist/ ophthalmologist. Key Words: Opticians, Contact lenses, Bacterial Keratitis.

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