Mini-scleral lenses in the visual rehabilitation of patients after penetrating keratoplasty and deep lamellar anterior keratoplasty

Alipour, Fateme; Behrouz, Mahmoud Jabarvand; Samet, Behnaz

doi:10.1016/j.clae.2014.10.001

Cited by 39 publications

(45 citation statements)

References 35 publications

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“…As previously noted the nasal side sinks significantly more than the temporal side by 23.0±7.3 μm (F [1,12]=10.043; p=0.008; 95%CI: [ 7.2, 38.9]). This difference is significant with time (F=8.757; p<0.001) and there is a side effect (F=10.043; p=0.008).…”

Section: Comparison: Nasal Sink Versus Temporal Sinksupporting

confidence: 62%

Conjunctival Inlapse: Nasal and Temporal Conjuctival Shape Variations associated with Scleral Lens Wear

Courey

Michaud

2018

JCLRS

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PURPOSE: This article aims to report a new clinical finding associated with the wear of scleral lenses. METHODS: Non-contact lens wearer subjects were recruited and fitted with large diameter (18 mm) scleral lenses. Lens was randomly filled with non preserved saline or non preserved carboxymethylcellulose-based artificial tears (Refresh Celluvisc, Allergan, Ca). The sinking of the lens on the nasal and temporal sclera was assessed periodically during a total of 6h00 of wear, with the use of anterior segment coherence tomography (OCT- Optovue, Clarion Technologies, Texas). Images were taken every 30 minutes for the first 2h00, then at 4h00 and 6h00 post-insertion. RESULTS: The nasal side sinks significantly more than the temporal side by 23.0±7.3 μm (F(1,12)=10.043; p=0.008; 95%CI:[7.2 ,38.9]). This difference is significant with time (F=8.757; p<0.001) and there is a side effect (F=10.043; p=0.008). The type of solution does not influence the lens behavior (F=0.250; p=0.626). A new clinical finding was revealed during scan analysis. Conjunctival tissue displacement was seen, under the reverse curve of the scleral lens, shortly after insertion. This conjunctival “inlapse” (CI) was sustained over all the wearing hours. On the nasal quadrant, CI was reduced in height and present in only 8/15 subjects while, in the temporal quadrant, 100% of subjects showed an average CI of 38.39 ± 10.43 μm (t(84)=3.68; p=0.0072; 95%CI[17.64, 59.13]) 30 minutes post insertion followed by a non-significant decrease of 1.97 ± 10.34 μm (t(84)=0.19; p=1.00; 95%CI[-22.52,18.58]) between 30 minutes and 6 hours of wear. CONCLUSION: Nasal sinking is more pronounced as compared with temporal lens sinking. This may explain the occurrence of a new clinical phenomenon identified to happen shortly after lens insertion, under the reverse curve of a scleral lens. In fact, CI happens mostly on the temporal quadrant, where more space is available for the conjunctival tissue to move. This finding suggests that conjunctival tissue reacts to scleral lens wear, not only in the inferior quadrant, where conjunctival prolapse is known to occur, but in every other one as well.

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Section: Comparison: Nasal Sink Versus Temporal Sinksupporting

confidence: 62%

Conjunctival Inlapse: Nasal and Temporal Conjuctival Shape Variations associated with Scleral Lens Wear

Courey

Michaud

2018

JCLRS

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“…4 Other studies showed a much lower rate of abandoning ScCL due to handling problems. [5][6][7][8][9][10] One study broke down handling difficulty establishing that with application, 20% of patients had mild difficulty while 12% had moderate difficulty; and with removal, only 9% of patients had mild difficulty. 11 Kornberg and Wang found that application and removal was not a laborious process.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Whereas, other studies have debunked difficulties with ScCL handling. 1,[5][6][7][8][9][10][11][12] ScCL complications related to handling are rare and most are managed without any lasting side-effects. It is crucial that patients understand the application and removal process and are trained in handling ScCL as patients may have initial difficulty with this process.…”

mentioning

confidence: 99%

Scleral Lens Issues and Complications Related to Handling, Care and Compliance

Fadel

Toabe

2018

JCLRS

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Scleral contact lens (ScCL) handling may be challenging and is the principle reason for ScCL drop out. ScCL care systems are more intricate than other lens modalities and include solutions for cleaning, disinfection, storing, rinsing and filling the lens; respecting the use of each solution recommended is fundamental. Replacement of the lenses, solutions, case and plungers are important in order to decrease the risk of adverse events associated with ScCL wear. Compliance is crucial regarding hygiene, solution use, case and plunger care, wear time, follow-up schedule, and handling techniques. Non-compliance may lead to discontinuation of ScCL due to difficulties associated with this unique lens design. This paper presents complications secondary to handling, care and compliance that clinicians and patients may encounter while wearing ScCL. Instructions are provided to enhance the understanding on management surrounding these issues. This manuscript includes three tables to summarize types of complications, their symptoms, clinical signs, etiology, and management for a quick find index for easy consultation during daily clinical practice.

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“…Rigid highly gas permeable contact lenses have gained more popularity nowadays, especially in the patients with concomitant high astigmatizm [15,16]. Central corneal opacity is an issue in the RGP use especially at the bearing point on the cornea.…”

Section: Discussionmentioning

confidence: 99%

“…In many of the patients, after primary repair and lensectomy, it is impossible to insert the intraocular lens (IOL) in the remnants of the capsular bag if any remnant exists. Occasionally, in traumatic aniridia, iris fixation is even impossible, and scleral fixation remains the only surgical option in these cases; however, visual acuity remains poor because of the concomitant irregular astigmatism that would not be eliminated by IOL implantation [1]. In traumatic aphakia, as a result of the trauma suffered by the patient, the patient loses his phakic lens and no anatomic structure is available in the damaged eye to attach the intraocular lens (IOL).…”

Section: Introductionmentioning

confidence: 99%

Clinical Course Followed Up in Contact Lens Applications of Traumatic Aphakia Contact Lens Applications of Traumatic Aphakia

Kazanci¹,

Kavuncu²,

Özek³

et al. 2017

J Clin Exp Ophthalmol

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Aim: To compare the clinical results of vision rehabilitation performed with contact lens in aphakic patients who underwent surgery due to ocular trauma. Methods:A total of 29 eyes of 29 patients who developed aphakia following ocular trauma and used contact lenses for aphakia, followed up from September 2003 to February 2015 were included examined. Their age, gender, best visual acuity with contact lenses (BVACL), the kind of contact lenses they used, their reasons for stopping the use of contact lenses or changing them and the complications related to contact lenses were recorded.Results: Out of the 29 patients, 8 were women and 21 men. Their average age was 36.5 ± 15.8 (12 to 61) years. Out of the 21 subjects who used hydrogel contact lens (Net Lens), 3 of them were applied cosmetic soft contact lens (Net lens 55 proesthetic) due to aniridia, rigid gas permeable contact lens (RGPCL) were applied to 5 of the patients, hydrogel lens (Weicon CE) with 60% water content to 2 of the patients and Elastofilcon A (Silsoft) to one. According to the Snellen eye chart BVACL was 0.5 and above in 8 of the patients (27.6%), between 0.2 to 0.4 in 18 of the patients (62%) and below 0.1 in 3 of the patients (10.4%). Eight of the subjects (27.6%) stopped using contact lenses during their follow-up. Conclusion:Good quality and dependable eye sight rehabilitation is obtained by the use of contact lenses in aphakia connected to trauma.

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Mini-scleral lenses in the visual rehabilitation of patients after penetrating keratoplasty and deep lamellar anterior keratoplasty

Cited by 39 publications

References 35 publications

Conjunctival Inlapse: Nasal and Temporal Conjuctival Shape Variations associated with Scleral Lens Wear

Conjunctival Inlapse: Nasal and Temporal Conjuctival Shape Variations associated with Scleral Lens Wear

Scleral Lens Issues and Complications Related to Handling, Care and Compliance

Clinical Course Followed Up in Contact Lens Applications of Traumatic Aphakia Contact Lens Applications of Traumatic Aphakia

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