High-Dk Piggyback Contact Lenses Over Intacs for Keratoconus: A Case Report

Smith, Kyle A.; Carrell, James D.

doi:10.1097/icl.0b013e31815b7d91

Cited by 26 publications

(17 citation statements)

References 19 publications

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“…[2122242526] However, the greatest flattening effect of the ring segment is exerted on the mid-peripheral region of the cornea directly over the ICRS which creates an abnormal artificial steepening of the peripheral cornea relative to the mid-periphery; this can make RGP fitting difficult. [151617]…”

Section: Discussionmentioning

confidence: 99%

“…[1516173031] There is only one case report of MSD contact lens fitting in advanced keratoconus with INTACS. Recently, Dalton and Sorbara described one patient with keratoconus who was successfully fitted with a mini scleral contact lens for residual refractive error after ICRS surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[13] Corneal inlay implantation may result in a multifocal cornea with a steeper corneal periphery and flatter mid-periphery. [151617] Higher order aberrations (HOAs) in keratoconic eyes are much larger than those in normal eyes, and coma-like aberrations are dominant as compared with spherical-like aberrations. [18] Some studies have reported that rigid gas permeable (RGP) contact lenses improve visual performance by reducing HOAs in keratoconic eyes.…”

Section: Introductionmentioning

confidence: 99%

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Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Alipour

Rahimi

Hashemian

et al. 2016

J Ophthalmic Vis Res

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Purpose:To evaluate the feasibility and efficacy of mini-scleral design (MSD) contact lenses to treat keratoconus patients who were unsatisfied with the results of corneal inlay.Methods:In this prospective interventional case series, 9 eyes of 6 keratoconus patients who were unsatisfied with the results of corneal inlay were fitted with MSD contact lenses. Demographic data, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and higher order aberrations (HOAs) were evaluated before contact lens fitting. Corrected visual acuity by placing the MSD contact lens with or without over-refraction, and HOAs were measured one hour after contact lens fitting. One month after contact lens wearing, corrected visual acuity by placing the MSD contact lens with over-refraction and possible contact lens related problems were assessed. Ocular comfort and contact lens handling problems were asked in follow-up visits. The data was analyzed using descriptive statistical tests.Results:Nine eyes of 6 patients were successfully fitted with the mini-scleral lens. Fitting was ideal in 7 eyes and acceptable in 2 eyes. Mean corrected visual acuity by placing the MSD lens without over-refraction was 0.09 (range, 0.00-0.15) LogMAR which was significantly better than the mean BSCVA of 0.38 (range, 0.2-0.6) LogMAR (P = 0.007). The mean root mean square (RMS) of third-order coma and trefoil significantly decreased after MSD contact lens fitting (P = 0.012 and P = 0.015, respectively); however, changes in the fourth-order spherical aberration were not statistically significant (P = 0.336).Conclusion:Mini-scleral contact lenses may be helpful in the management of visually unsatisfied patients after corneal inlay.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Alipour

Rahimi

Hashemian

et al. 2016

J Ophthalmic Vis Res

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“…Later, Smith & Carre [22] all discussed the fit of a high DK/t Paflufocon B (58) rigid gas permeable lens on a pure vision disposable soft contact lens in a piggyback system that was well tolerated by an advanced stage keratoconus patient having implanted Intacs. The disposable soft contact lens was easily replaced to compensate for the fluctuations in refractive error.…”

Section: Clinical Aspects Of the Piggyback Systemmentioning

confidence: 99%

Piggyback Lens System in the Management of Keratoconus

Manal¹

2015

AOVS

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A review of literature on the use of Piggyback contact lens system in the management of Keratoconus. Factors discussed included the oxygen transmission through the dual lens system, lens material, cost, and rate of contact lenses related complications. One the most important raised questions are: does this lens system fulfill the definite goal in the management of Keratoconus which is best optical correction along which least corneal insult.

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“…Irregular high corneal astigmatism can be seen in keratoconus, 4 pellucid marginal degeneration, 5 keratoplasty, 6 post-LASIK ectasia 7 and corneal ring segment implantation. 8 These conditions lead to poor visual acuity with glasses or conventional soft contact lenses. Rigid gas-permeable (RGP) contact lenses are considered the best optical solution for patients with irregular corneas for its masking corneal irregularity and optical aberration by creating a tear layer between the lens and the cornea.…”

mentioning

confidence: 99%

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

Mishra¹,

Dhungel²,

Aryal

2015

J Chitwan Med Coll

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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.

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High-Dk Piggyback Contact Lenses Over Intacs for Keratoconus: A Case Report

Abstract: Patients with Intacs for keratoconus may require a combination of soft and rigid contact lenses for the best possible VA. Contact lens fitting with a high-Dk piggyback contact lens system can provide optimal comfort, corneal health, and VA for patients with Intacs for keratoconus.

Cited by 26 publications

References 19 publications

Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Piggyback Lens System in the Management of Keratoconus

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

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