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

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.

scholarly journals Corneal Thinning after Contact Lens-related Infective Keratitis

2014 ◽  
Vol 3 (2) ◽  
pp. 95-98
Author(s):  
José Salgado-Borges ◽  
Renata Siqueira ◽  
Raquel Almeida ◽  
Filipa Rodrigues ◽  
Matheus Santos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Case Reports ◽  
Corneal Thickness ◽  
Corneal Opacity ◽  
Infectious Keratitis ◽  
Visual Rehabilitation ◽  
First Case ◽  
Corneal Thinning

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.

Outcomes of sequential intracorneal ring segment and phakic intraocular lens insertion for visual rehabilitation in keratoconus

2020 ◽  
pp. 112067212096960
Author(s):  
Cameron A McLintock ◽  
James McKelvie ◽  
Sara Miraflores Gomez ◽  
Zisis Gatzioufas ◽  
Mohamed Elalfy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Phakic Intraocular Lens ◽  
Visual Rehabilitation ◽  
Iol Implantation ◽  
Phakic Iol ◽  
Refractive Outcomes ◽  
Ring Segment ◽  
The Mean ◽  
Intracorneal Ring Segment

Purpose: To report the visual and refractive outcomes of sequential intracorneal ring segment (ICRS) and toric phakic intraocular lens (IOL) insertion for visual rehabilitation in keratoconus. Methods: A retrospective interventional cohort study was performed through the Corneoplastics unit and Eye Bank, Queen Victoria Hospital, East Grinstead, United Kingdom. Results: 14 eyes of 12 patients had sequential ICRS and phakic IOL implantation for visual rehabilitation of keratoconus between June 2014 and February 2018. After at least 6 months follow-up, the number of eyes with an uncorrected distance visual acuity (UDVA) of 20/40 UDVA or better increased from zero (0%) to 10 (71%). 12 (85.7%) eyes achieved a post-operative UDVA equal to or better than the pre-operative corrected distance visual acuity (CDVA). The number percentage of eyes with a CDVA of 20/40 or better increased from 3 (31%) to 14 (100%). The mean final spherical equivalent improved from −4.07 to −0.17 ( p ⩽ 0.001). The mean refractive astigmatism magnitude improved from 4.76D to 1.23D ( p = 0.002). Seven (50%) eyes had 1.0D or less of refractive astigmatism post-operatively. Conclusion: In this cohort of eyes with keratoconus, sequential ICRS and phakic IOL implantation resulted in excellent visual and refractive outcomes after at least 6 months.

Intracorneal circular ring implant with femtosecond laser: Pocket versus tunnel

2021 ◽  
pp. 112067212199472
Author(s):  
Luis Izquierdo ◽  
Ana M Rodríguez ◽  
Ramón A Sarquis ◽  
Diego Altamirano ◽  
Maria A Henriquez
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Randomized Study ◽  
Circular Ring ◽  
Continuous Ring ◽  
Refractive Outcomes ◽  
Scheimpflug Imaging ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
Student’S T

Purpose: To evaluate and compare visual and refractive outcomes after implantation of the intracorneal continuous ring 360° arc (ICCR) versus the intracorneal ring segment 340° arc (ICRS) using femtosecond laser for central keratoconus. Setting: Research Department, Oftalmosalud, Instituto de Ojos, Lima, Peru. Methods: Randomized study that included 40 eyes of 32 patients diagnosed with central keratoconus between November 2014 and March 2015. Twenty eyes had an implantation of ICCR (MyoRing, Dioptex GmbH, Austria) through an intrastromal pocket and 20 eyes had an implantation of ICRS (Keraring, Mediphacos, Brazil) through an intrastromal tunnel. Both procedures were performed with a femtosecond laser (LDV Z6 model, Ziemer Ophthalmic Systems AG). Visual acuity (VA), refraction, and Scheimpflug imaging analysis were performed pre- and postoperatively at 1 month and 1 year. Comparisons of means were performed using the Student’s t-test. Results: At 1 year, uncorrected VA improved 0.77 LogMAR ( p < 0.001) in the ICCR group and 0.79 LogMAR ( p = 0.01) in the ICRS group; mean sphere improvement was 5.13 Diopters (D) in the ICCR group and 6.27 D in the ICRS group ( p < 0.001 both); mean Steeper Keratometry improvement was 4.24 D in the ICCR group and 5.53 D in the ICRS group ( p < 0.001 both). In the ICCR group, mean decrease in the pachymetry at the thinnest point of the cornea was 32.16 µm ( p = 0.01), and in the ICRS group, mean increase was 4.2 µm at 1 year ( p = 0.61). Conclusion: Intracorneal continuous ring 360° arc (ICCR) and intracorneal ring segment 340° (ICRS) are effective treatments for central keratoconus. No significant differences between rings were found on visual acuity, refraction, and keratometry improvement.

scholarly journals Long-term Stability of Ectasia in a Young Patient with Asymmetric Keratoconus

2015 ◽  
Vol 4 (2) ◽  
pp. 66-68
Author(s):  
Rosane de Oliveira Corrêa ◽  
Ana Laura Caiado Canedo ◽  
Rozalia Beildeck ◽  
Marcella Quaresma Salomão ◽  
Penelope Burle de Politis
Keyword(s):  
Visual Acuity ◽  
Young Patient ◽  
Distance Visual Acuity ◽  
Long Term Stability ◽  
Uncorrected Distance Visual Acuity ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
The Right

ABSTRACT Purpose To report the clinical course of a typical young patient presenting with asymmetric keratoconus (KC), that demonstrates that stabilization of the ectatic process is possible without cross-linking (CXL) procedure. Methods Case report and review of the literature. Results A 17-year-old male patient was referred due to the diagnosis of keratoconus. Patient complained of loss of vision in the left eye (OS). Uncorrected distance visual acuity (UDVA) was 20/25+ in the right eye (OD) and 20/80 in the left eye; wavefront-assisted manifest refraction gave best corrected distance visual acuity (CDVA) of 20/20 in OD and 20/40 in OS. The diagnosis of keratoconus was confirmed with Placido disk-based topography (Oculus Keratograph 4), and Pentacam HR corneal tomography (Oculus Optikgeräte GmbH, Wetzlar, Germany). Femtosecond laser-assisted intracorneal ring segment (ICRS) implantation was performed in the left eye and treatment for allergy was prescribed for both eyes, along with patient education and advice not to rub the eyes. After 3 months, significant improvement was observed on UDVA (20/30) and CDVA (20/20) in the left eye. Topometric and tomographic stability of ectasia was observed in the right eye in a 4-year follow-up. Conclusion Intracorneal ring segment caused significant regularization of the corneal shape and improvement on visual acuity. Ectasia stability was achieved with no need for CXL, despite the patient's young age. This case raises the point that the indication of CXL for every keratoconic patient should be reconsidered. How to cite this article de Oliveira Corrêa R, Canedo ALC, Beildeck R, Salomão MQ, de Politis PB, Ambrósio R Jr. Longterm Stability of Ectasia in a Young Patient with Asymmetric Keratoconus. Int J Kerat Ect Cor Dis 2015;4(2):66-68.

Unilateral Ectasia characterized by Advanced Diagnostic Tests

2016 ◽  
Vol 5 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Bernardo Lopes ◽  
Marcella Q Salomão ◽  
Isaac C Ramos ◽  
Fernando Faria-Correia
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Diagnostic Tests ◽  
Diagnostic Methods ◽  
Distance Visual Acuity ◽  
Epithelial Thickness ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
The Right

ABSTRACT To describe a case of very asymmetric ectasia successfully treated by femtosecond laser-assisted intracorneal ring segment implantation, in which the diagnosis of unilateral ectasia in the right eye was based on the clinical findings including history, follow-up, and advanced diagnostic data. The patient's history was positive for ocular allergy with moderate- to-intense eye rubbing only in the right eye. The uncorrected distance visual acuity was 20/63 in the right eye and 20/32 in the left eye. The corrected distance visual acuity (CDVA) was 20/40 in the right eye (-1.75-4.00 × 35°) and 20/16 in the left eye (-0.50-0.25 × 115°). After femtosecond laser-assisted intracorneal ring segment implantation, the right eye improved CDVA to 20/20-1. Concerning ectasia/keratoconus diagnosis, the left eye remained stable over 1 year of follow-up with unremarkable topometric, tomographic, and biomechanical findings. Epithelial thickness mapping by spectral domain optical coherence tomography and very-high-frequency digital ultrasound demonstrated epithelial thickness within normal limits in the left eye. Advanced diagnostic methods along with clinical data enable the distinction from unilateral ectasia cases and subclinical (fruste) keratoconus. Literature review is also performed along with case presentation and discussion. How to cite this article Ramos IC, Reinstein DZ, Archer TJ, Gobbe M, Salomão MQ, Lopes B, Luz A, Faria-Correia F, Gatinel D, Belin MW, Ambrósio R Jr. Unilateral Ectasia characterized by Advanced Diagnostic Tests. Int J Kerat Ect Cor Dis 2016;5(1):40-51.

scholarly journals Pre-Descemetic Placement of Intracorneal Ring Segments for Keratoconus after Mechanical Implantation

2021 ◽  
pp. 940-943
Author(s):  
Faady Yahya ◽  
Christian F. Prünte ◽  
Hendrik P.N. Scholl ◽  
Zisis Gatzioufas
Keyword(s):  
Visual Acuity ◽  
High Resolution ◽  
Femtosecond Laser ◽  
Anterior Segment ◽  
Slit Lamp ◽  
Anterior Segment Oct ◽  
Ring Segment ◽  
Intracorneal Ring Segment

We report the case of a 23-year-old male who was referred to our clinic for a routine follow-up examination. The patient was treated for keratoconus 3 years ago in Colombia, where intracorneal ring segments were implanted mechanically in both eyes to improve his visual acuity. Surprisingly, we discovered a pre-descemetic placement of intracorneal ring segments, which could lead to potential complications, under circumstances. We illustrate this impressive finding with slit-lamp photography and high-resolution anterior segment OCT and advocate for the use of femtosecond laser as the method of choice for intracorneal ring segment insertion in order to provide maximal precision and safety.

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 Characterization of the effect of intracorneal ring segment in corneal ectasia after laser refractive surgery

2018 ◽  
Vol 30 (1) ◽  
pp. 125-131
Author(s):  
Cristina Peris-Martínez ◽  
Inmaculada Bueno-Gimeno ◽  
Izaskun Alvarez-Arana ◽  
David P Piñero ◽  
Andrés Gené-Sampedro
Keyword(s):  
Visual Acuity ◽  
Vector Analysis ◽  
Distance Visual Acuity ◽  
Corneal Ectasia ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
Power Measurements

Purpose: To evaluate the visual, refractive, topographic, pachymetric, and biomechanical outcomes after intracorneal ring segment implantation in corneas with post-LASIK ectasia. Methods: Retrospective longitudinal study enrolling 26 eyes of 22 patients with post-LASIK ectasia and undergoing intracorneal ring segment implantation (KeraRing®, Mediphacos) using a 60-kHz femtosecond laser (IntraLase®, IntraLase Corp.) for corneal tunnelization. Visual, refractive, anterior, and posterior corneal topographic (Pentacam HR, Oculus), pachymetric, and corneal biomechanical changes (Ocular response Analyzer, Reichert) were evaluated during a 12-month follow-up. Vector analysis of astigmatic changes was performed. Results: A statistically significant reduction of sphere (p = 0.043) was observed at 1 month after surgery, with a significant improvement of uncorrected distance visual acuity associated (p = 0.019). Likewise, a significant reduction of anterior corneal power measurements (p ⩽ 0.014) and steepest posterior keratometric reading (p = 0.006) were observed at 1 month postoperatively, with no significant changes afterwards (p ⩾ 0.133). No significant changes were observed in manifest cylinder (p ⩾ 0.175), corrected distance visual acuity (p ⩾ 0.174), flattest posterior keratometric measurement (p ⩾ 0.282), volumetric measurements (p ⩾ 0.051), and corneal biomechanical parameters (p ⩾ 0.068). Vector analysis revealed an initial trend to overcorrection of astigmatism, with a trend to undercorrection at the end of follow-up and a significant variability in the outcome achieved in each patient. Conclusion: The implantation of KeraRing segments in post-LASIK corneal ectasia generates a significant modification of spherical refraction and a visual improvement due to a central corneal flattening generated. More refined nomograms of implantation in these cases should be developed to achieve a more predictable correction of astigmatism.

scholarly journals Visual outcome on Fitting Rose-K2 XL lens in a case with Terrien’s marginal degeneration

2015 ◽  
Vol 4 (4) ◽  
pp. 49-51 ◽  
Author(s):  
S K Mishra ◽  
G S Shrestha ◽  
P Dhungel ◽  
B Aryal
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Visual Outcome ◽  
Corneal Astigmatism ◽  
Good Visual Acuity ◽  
Uncommon Disease ◽  
Optical Zone ◽  
Peripheral Cornea ◽  
Irregular Astigmatism ◽  
Corneal Thinning

Terrien’s marginal degeneration is an uncommon disease of the peripheral cornea occurring at any age that results in corneal thinning causing corneal irregular astigmatism. RoseK2 XL lens has an aspheric optical zone and employed in the fitting of irregular corneas for vision and comfort while maintaining corneal health. Rose K2 XL lens was fitted in a 17 year female presented to Contact lens clinic of B.P. Koirala Lions Center for Ophthalmic Studies, Kathmandu having RE Terrien’s marginal degeneration. Her presenting visual acuity was 6/60 in right eye and 6/6 in left eye with best subjective refraction OD: +2.00/-3.00X150 and OS: Plano. Her corneal topography revealed irregular corneal astigmatism as indicated by SimK49.85/41.63@137. RoseK2 XL which is a mini-scleral lens, showed an excellent fitting attaining visual acuity 6/6. RoseK2 XL lens provides not only good visual acuity also confirms comfort in patients with corneal marginal degeneration.DOI: http://dx.doi.org/10.3126/jcmc.v4i4.11974

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