scholarly journals Advances in Non-surgical Treatment Methods in Vision Rehabilitation of Keratoconus Patients

2021 ◽  
Author(s):  
Ersin Muhafiz
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Corneal Neovascularization ◽  
Advanced Stage ◽  
Vision Rehabilitation ◽  
Non Surgical Treatment ◽  
Giant Papillary Conjunctivitis ◽  
Irregular Astigmatism ◽  
Good Vision

Visual acuity decreases due to progressive irregular astigmatism in keratoconus (KC). Although glasses can be useful in the initial stages of vision rehabilitation, contact lenses (CL) are needed in many patients due to irregular astigmatism. Although rigid gas permeable (RGP) CLs provided the patient with a better visual acuity than glasses, their effects on corneal tissues and caused comfort problems. Although soft CL produced for KC have solved some of these problems, they could not increase visual acuity as much as RGPs in advanced stage KC. For this reason, new searches for vision rehabilitation and comfort in KC have continued. In this context, piggyback contact lenses (PBCL) have been used in vision rehabilitation. Hybrid CLs have gained popularity due to the fact that PBCLs cause corneal neovascularization and giant papillary conjunctivitis. Scleral CLs have been developed for limited benefit in some patients with advanced KC. Scleral CLs provided good vision rehabilitation. The biggest problem of scleral CLs is the application and removal difficulty. All these CL modalities try to improve the quality of life and delay surgical procedures by increasing the level of vision in patients with KC.

scholarly journals Custom contact lenses and cornea-scleral contact lenses from irregular astigmatism

2020 ◽  
Vol 10 (2) ◽  
pp. 41-43
Author(s):  
Pérez Silguero D ◽  
Encinas Pisa P ◽  
Bermal Blasco I ◽  
Pérez Silguero MA ◽  
Perez Silguero D ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Contact Lenses ◽  
Case Reports ◽  
Eye Care ◽  
Soft Contact ◽  
Soft Contact Lenses ◽  
Visual Problems ◽  
Irregular Astigmatism

Objective: To show the improvement of visual acuity in five clinical cases of irregular astigmatism, achieved with contact lenses of different materials and geometries. Case reports: Five case reports are exposed and their adaptations for the use of this type of lenses are evaluated. After inserting corneo-scleral lenses or soft contact lenses, each adaptation is evaluated. Results: All patients have improved meaningfully their visual acuity without affecting their corneal integrity and improving their quality of life. Conclusion: Advances in the design and materials of contact lenses have helped eye-care professionals to solve visual problems that would have been difficult to solve years ago. Keywords: irregular astigmatism, keratoconus, keratoplasty, custom contact lenses, cornea-scleral contact lenses

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.

Overview of pharmacological treatments for presbyopia

2021 ◽  
Vol 1 (2) ◽  
pp. 67-77
Author(s):  
Betina Orman ◽  
Giovanna Benozzi
Keyword(s):  
Pharmacological Treatment ◽  
Contact Lenses ◽  
English Literature ◽  
Crystalline Lens ◽  
Surgical Strategies ◽  
Non Invasive ◽  
Near Visual Acuity ◽  
Over 40 Years ◽  
Good Vision

Background: Presbyopia is the normal progressive waning of accommodation with loss of the visual ability to focus on objects residing at different distances. Presbyopia exacts a cost in quality of life and professional efficiency of many people over 40 years of age. Presbyopia is likely to be 1 of the main pressing visual concerns of the 21st century, given that life expectancy is increasing, resulting in an aging population. This review aimed to address the 3 strategies of the pharmacological treatment for presbyopia. Methods: A review on PubMed/MEDLINE, Google Scholar, and Clinicaltrials.gov was performed to investigate the English literature on pharmacological treatment for presbyopia from beginning-of-year 2012 to September 30, 2020. Results: In addition to the treatment of presbyopia with glasses or contact lenses, new surgical strategies have been developed, some of which have been successful. However, during the last decade, a new, promising, non-invasive option for treating presbyopia has emerged: the pharmacological approach. Many researchers have developed 3 different lines of investigation from different assumptions, on a pharmacological basis. The first consisted of producing miosis, to take advantage of a pharmacologically induced pinhole effect, increasing depth-of-focus, and thus improving uncorrected near visual acuity. The second aimed to rehabilitate accommodation binocularly to enable good vision at all distances. Finally, the third approach attempted to rehabilitate lost elasticity in the human crystalline lens. Conclusions: None of the 3 discussed pharmacological strategies for treating presbyopia, prescribed globally, but patients of restoring accommodation strategy can adhere locally, where they are sold so far as master prescriptions.

Keratoconic Bi-aspheric Contact Lenses

2016 ◽  
Vol 5 (3) ◽  
pp. 132-138
Author(s):  
Ariela Gordon-Shaag ◽  
Philip Fine ◽  
Liat Gantz ◽  
Arige Gideon-Abousaid ◽  
Gad Serero
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Case Series ◽  
Visual Stability ◽  
Wavefront Aberrations ◽  
Body Sensation ◽  
Quality Of Vision ◽  
Base Curve ◽  
Aspheric Lenses

ABSTRACT Aim This observational clinical case series examined patients with keratoconus (KC) fit with keratoconic bi-aspheric (KBA) lenses to assess visual acuity (VA), wavefront aberrations, physiological fitting, subjective comfort, and manufacturer's fitting guidelines. Materials and methods Seven adult patients (11 eyes, four females, mean age: 34.15 ± 14.12) with nipple cones from the Hadassah Academic College contact lens clinic (Jerusalem, Israel) were fit with KBA lenses by modifying the initial base curve (BC) to obtain an acceptable physiological fit. The uncorrected and corrected distance (D) and near (N) Snellen VA and the ocular wavefront measurements, and responses to a self-administered five-point scale questionnaire were compared after 2 weeks of wear using paired two-tailed t-test or Mann-Whitney U test, as appropriate. Results Visual acuity and total root mean square (RMS) improved significantly with the lenses (DVAuncorrected = 0.04 ± 0.02, DVAcorrected = 0.66 ± 0. 22, NVAuncorrected = 0.34 ± 0.30, NVAcorrected = 0.95 ± 0.12). Subjects reported an average of 7.0 ± 2.7 hours of wear daily, with good scores in visual stability, satisfaction with VA and quality of vision, improvement of mood and quality of life, and low scores in foreign body sensation, pain, red eye, and itching during wear, and difficulty with lens removal. An average of two BC modifications from the diagnostic lens were necessary (0.16 mm steeper in nine eyes, 0.27 mm flatter in two eyes). Conclusion Keratoconic bi-aspheric lenses can provide 7 hours of comfortable wear, significantly improved VA and total RMS aberrations, alongside subjective satisfaction. Base curve modifications can be reduced by fitting a diagnostic lens 0.75 mm steeper than the flattest keratometry reading. How to cite this article Gantz L, Gordon-Shaag A, Gideon-Abousaid A, Serero G, Fine P. Keratoconic Bi-aspheric Contact Lenses. Int J Kerat Ect Cor Dis 2016;5(3):132-138.

scholarly journals Intacs Intracorneal Ring Segments Complications in Patients Suffering from Keratoconus

2013 ◽  
Vol 2 (3) ◽  
pp. 121-128 ◽  
Author(s):  
Ramez Barbara ◽  
Adel Barbara
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Postoperative Complications ◽  
Retrospective Studies ◽  
Contact Lenses ◽  
Case Reports ◽  
High Order ◽  
Positive Results ◽  
High Order Aberrations

ABSTRACT Intacs, intrastromal corneal rings are widely used to reduce myopia, astigmatism, keratometry readings and high order aberrations in patients suffering from keratoconus, almost 15 years have passed from the first procedure which was performed in the eye of a patient with unsatisfactory visual acuity and contact lenses intolerance. Many publications including book chapters, retrospective studies, case reports and literatures reviews have been published on this issue. In this review, we are reporting on the complications of Intacs implanted in keratoconic eyes, we are reporting on intraoperative and postoperative complications. The review although focusing on complications of the does not contradict the positive results of the procedure on the quality of life of the patients suffering from keratoconus and the its safety. How to cite this article Barbara A, Barbara R. Intacs Intracorneal Ring Segments Complications in Patients Suffering from Keratoconus. J Kerat Ect Cor Dis 2013;2(3):121-128.

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 Frequently Experienced Problems in the Early Stages after Prescribing Rigid Gas Permeable Contact Lenses

2021 ◽  
Vol 20 (4) ◽  
pp. 135-139
Author(s):  
Dong Ho Lee
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Contact Lenses ◽  
Foreign Body Sensation ◽  
Corneal Curvature ◽  
Slit Lamp ◽  
Body Sensation ◽  
Quality Of Vision ◽  
Slit Lamp Microscopy

Prescribing rigid gas-permeable (RGP) lenses involves a series of processes that determine the most appropriate final lens through the trial use of test lenses based on the results of slit lamp microscopy, measuring refraction and corneal curvature, and corneal topography. The final prescription is reached by judging the dynamic lens movement, adequacy of the tear layer around the lens, corrected vision, and quality of vision. Various problems are encountered soon after prescribing lenses, including foreign body sensation, tear hypersecretion, decreased visual acuity, blurring, visual acuity change, redness, dryness, sudden pain, lens centering, and lens fallout. Here, we examine these problems and how to solve them.

scholarly journals Quality of Vision with Spectacles, Special Silicone Hydrogel and Gas Permeable Contact Lenses in Keratoconic Patients

2013 ◽  
Vol 2 (2) ◽  
pp. 56-59 ◽  
Author(s):  
Jose M González-Méijome ◽  
Sofia Claudia Peixoto-de-Matos ◽  
Antonio Queiros ◽  
Jorge M Jorge ◽  
Alberto Diaz-Rey
Keyword(s):  
Visual Acuity ◽  
Contact Lens ◽  
Contact Lenses ◽  
Soft Contact ◽  
Low Contrast ◽  
Silicone Hydrogel ◽  
Soft Contact Lens ◽  
Quality Of Vision ◽  
Spectacle Correction

ABSTRACT Purpose To evaluate optical quality and visual function in keratoconus patients corrected with RGP contact lenses and a novel special design of silicone hydrogel contact lens. Materials and methods Twelve eyes of six patients with keratoconus were enrolled to experience a new soft contact lens (Soft-K) for keratoconus made of a silicone-hydrogel material and the outcomes were compared to the performance with gas permeable lenses and spectacles. The three situations were compared for monocular and binocular high (100%) and low contrast (10%) ETDRS LogMAR visual acuity and contrast sensitivity function (CSF). Results On average, there was an improvement of more than two lines in visual acuity over spectacle correction and this is statistically significant for both gas permeable (GP) and Soft-K lens (p < 0.001). Visual acuity was not significantly different between GP and Soft-K lens for high contrast acuity but was slightly higher with GP lens for low contrast under binocular conditions. Monocular CSF showed a marked improvement with the Soft-K lens and GP, compared to spectacles correction, particularly for medium and high frequencies; conversely. Conclusion Soft-K silicone hydrogel soft contact lens produces a clinical and statistically significant improvement in visual acuity and contrast sensitivity function over spectacle correction. How to cite this article González-Méijome JM, Peixoto-de- Matos SC, Queiros A, Jorge JM, Diaz-Rey A. Quality of Vision with Spectacles, Special Silicone Hydrogel and Gas Permeable Contact Lenses in Keratoconic Patients. Int J Kerat Ect Cor Dis 2013;2(2):56-59.

How to improve Visual Acuity after Intrastromal Corneal Ring Segments? Implantation for Keratoconus and Post-LASIK Ectasia

2014 ◽  
Vol 3 (2) ◽  
pp. 69-75 ◽  
Author(s):  
Ramez Barbara ◽  
Adel Barbara
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Dry Eyes ◽  
Intrastromal Corneal Ring ◽  
Anterior Lamellar Keratoplasty ◽  
Uncorrected Visual Acuity ◽  
Long Term Follow Up ◽  
Irregular Astigmatism

ABSTRACT Keratoconus (KC) is an ecstatic corneal disease that causes irregular astigmatism which cannot be corrected by glasses, the irregular astigmatism causes loss of visual acuity (VA) both the uncorrected and the corrected VA, in addition to deterioration in the quality of vision. Contact lenses (CLs) improve the VA but cannot be tolerated in many cases due to several causes, such as loss of motivation, atopic and allergic conjunctivitis that are more frequently associated with KC and dry eyes. Intrastromal corneal ring segments implanted in keratoconic eyes improve uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), reduce myopia, astigmatism, high order aberrations (HOA) and regularizes the cornea (less irregular astigmatism), similar results are achieved in the treatment of post-LASIK and post PRK ectasia. These results were confirmed in long-term follow-up. The more advanced the KC the more is the effect of the ICRS but the less the functional VA achieved and vice versa. Thicker rings are more effective, and the smaller the optical zone the more is the effect of the ICRS. The aim of ICRS implantation in KC is not to be free of glasses or CL but to enable the patient of seeing with glasses or to tolerate CL in order to prevent or delay the need for penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK). In many cases, we can achieve a functional and satisfactory UCVA with no need for glasses and this is the case in nonadvanced KC but not in the advanced cases. In some cases, the results achieved need additional means to improve VA in order to get satisfactory VA. There are nonsurgical and surgical means to improve VA after ICRS, these means will be reviewed in this article. How to cite this article Barbara A, Barbara R. How to improve Visual Acuity after Intrastromal Corneal Ring Segments? Implantation for Keratoconus and Post-LASIK Ectasia. Int J Kerat Ect Cor Dis 2014;3(2):69-75.

scholarly journals Peripheral Refraction, Wave Front of the Eye and Visual Performance in the Correction of Myopia in Children with Bifocal Soft Contact Lenses with High Addition

2021 ◽  
Vol 18 (3) ◽  
pp. 518-526
Author(s):  
E. P. Tarutta ◽  
S. V. Milash ◽  
M. V. Epishina
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Contact Lenses ◽  
Spherical Aberration ◽  
Sharp Decrease ◽  
Soft Contact ◽  
Wavefront Aberrations ◽  
Soft Contact Lenses ◽  
Soft Contact Lens

Purpose: to study the effect of bifocal soft contact lens (BSCL) with an ADD of 4 diopters on peripheral refraction (PR), optical and ergonomic eye parameters in children with myopia.Patients and methods. 26 patients (52 eyes) with myopia –3.09 ± 1.13 diopters at the age of 10.04 ± 1.5 years without correction and with correction by BSCL Prima BIO Bi-focal ( Okay Vision Retail, Russia). All patients underwent a horizontal and vertical PR study on an open field autorefractometer Grand Seiko WAM-5500 (Japan), wavefront aberrations were studied on OPD-Scan III aberrometer (Nidek, Japan), contrast sensitivity under mesopic conditions were studied on a Mesotest 2 instrument (Oculus, Germany) and visual productivity was studied using test tables.Results. The visual acuity of the distance with a BSCL correction of 0.98 ± 0.04 did not differ (p = 0.26) from the maximum visual acuity corrected by spherocylindrical glasses of 0.99 ± 0.04. BSCL induces myopic defocus in all peripheral zones, with a maximum value of 15° and a sharp decrease of 30°. Peripheral myopic defocus induced by the lens at a horizontal and vertical angle of 15 degrees did not depend on the initial degree of myopia. BSCL increases the total RMS from 0.07 ± 0.02 μm to 0.19 ± 0.07 μm in the 3 mm zone (p < 0.01) and from 0.27 ± 0.09 μm to 1.18 ± 0, 23 μm in the 6 mm zone (p < 0.01), mainly due to an increase in spherical aberration from –0.0005 ± 0.006 μm to 0.06 ± 0.01 μm (p < 0.01) and from 0.01 ± 0.09 μm to 0.58 ± 0.14 μm (p < 0.01) in the 3 mm and 6 mm zones, respectively. An increase in the overall RMS in BSCL reduces the quality of eye optics and contrast sensitivity under mesopic conditions, but does not impair visual productivity.Conclusion. BSCLs with a high ADD of 4 diopters are capable of inducing significant myopic peripheral defocus due to the induction of spherical aberration, while maintaining high visual acuity and not changing ophthalmic ergonomics, which makes them a pathogenetically substantiated method for correcting myopia and preventing its progression in children and adolescents.

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