Scleral Lens Visual Rehabilitation of Sequential Bilateral Corneal Hydrops With Post-LASIK Ectasia

Kumar, Mukesh; Shetty, Rohit; Lalgudi, Vaitheeswaran Ganesan; Khamar, Pooja; Vincent, Stephen J.

doi:10.1097/icl.0000000000000766

Cited by 4 publications

(9 citation statements)

References 12 publications

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“…Severe keratoconus may result in corneal hydrops, characterised by marked corneal oedema due to a break in the posterior limiting lamina, which allows aqueous to enter the corneal stroma and epithelium. Although hydrops can be selflimiting within ~3 months, acute cases may require corneal suturing or intracameral gas injection depending upon the severity [149]. Corneal hydrops can results in central vision-impairing scar tissue and corneal irregularity, necessitating in many cases the need for scleral contact lenses to achieve functional vision [150], and in some cases corneal transplantation [84].…”

Section: Clinical Featuresmentioning

confidence: 99%

Keratoconus: An updated review

Santodomingo-Rubido

Carracedo

Suzaki

et al. 2022

Contact Lens and Anterior Eye

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330

204

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Keratoconus is a bilateral and asymmetric disease which results in progressive thinning and steeping of the cornea leading to irregular astigmatism and decreased visual acuity. Traditionally, the condition has been described as a noninflammatory disease; however, more recently it has been associated with ocular inflammation. Keratoconus normally develops in the second and third decades of life and progresses until the fourth decade. The condition affects all ethnicities and both sexes. The prevalence and incidence rates of keratoconus have been estimated to be between 0.2 and 4,790 per 100,000 persons and 1.5 and 25 cases per 100,000 persons/year, respectively, with highest rates typically occurring in 20-to 30-year-olds and Middle Eastern and Asian ethnicities. Progressive stromal thinning, rupture of the anterior limiting membrane, and subsequent ectasia of the central/paracentral cornea are the most commonly observed histopathological findings. A family history of keratoconus, eye rubbing, eczema, asthma, and allergy are risk factors for developing keratoconus. Detecting keratoconus in its earliest stages remains a challenge. Corneal topography is the primary diagnostic tool for keratoconus detection. In incipient cases, however, the use of a single parameter to diagnose keratoconus is insufficient, and in addition to corneal topography, corneal pachymetry and higher order aberration data are now commonly used. Keratoconus severity and progression may be classified based on morphological features and disease evolution, ocular signs, and index-based systems. Keratoconus treatment varies depending on disease severity and progression. Mild cases are typically treated with spectacles, moderate cases with contact lenses, while severe cases that cannot be managed with scleral contact lenses may require corneal surgery. Mild to moderate cases of progressive keratoconus may also be treated surgically, most commonly with corneal crosslinking. This article provides an updated review on the definition, epidemiology, histopathology, aetiology and pathogenesis, clinical features, detection, classification, and management and treatment strategies for keratoconus.

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Section: Clinical Featuresmentioning

confidence: 99%

Keratoconus: An updated review

Santodomingo-Rubido

Carracedo

Suzaki

et al. 2022

Contact Lens and Anterior Eye

Self Cite

330

204

View full text Add to dashboard Cite

show abstract

“…24 Although not included in the results of this review, there are also some case reports, such as the one published by Kumar et al that support this position. 37 It should be noted that in their study, Woodward et al describe 20% of failure rate with RGPCL in patients with postoperative ectasia, such as discomfort and intolerance to lens wear, inability to fit the shape of the ectatic cornea properly, or poor visual acuity with lenses. 36…”

Section: Corneal Ectasia After Refractive Surgerymentioning

confidence: 89%

“…Although they are not included in this review, it is worth mentioning that there are many case reports that support these results. 37,38,[48][49][50] Several authors have shown a decrease in OSDI and an improvement in the NEI-VFQ-25 questionnaire in these patients after CL adaptation 8,44,47,49,51 In this regard, Tougeron-Brousseau et al reported how the adaptation of SL influences patients' visionassociated quality of life. They reported that 92% of their patients were successfully adapted, all of them showing an improvement in OSDI and in NEI VFQ-25, with an average value that went from 76.9 to 37.1 in the former and an improvement from 25.1 to 67.4 in the last, after CL adaptation.…”

Section: Severe Ocular Dryness and Ocular Surface Diseasesmentioning

confidence: 92%

“…24,26,[36][37][38] Although Woodward et al defend an improvement in functional VA using RGPCL in these patients as a therapeutic alternative to corneal transplantation, 36 Lo et al conversely defend the use of SL, by obtaining a better adaptation in patients compared with other therapeutic options such as glasses or RGPCL, reporting that vision improvement is usually notable after adaptation. 37 Navel et al reported similar outcomes. 24 Although not included in the results of this review, there are also some case reports, such as the one published by Kumar et al that support this position.…”

Section: Corneal Ectasia After Refractive Surgerymentioning

confidence: 99%

“…When ectasia is a consequence of refractive surgery, visual rehabilitation may be successful by fitting RGPCL or SL. 24,26,[36][37][38] Although Woodward et al defend an improvement in functional VA using RGPCL in these patients as a therapeutic alternative to corneal transplantation, 36 Lo et al conversely defend the use of SL, by obtaining a better adaptation in patients compared with other therapeutic options such as glasses or RGPCL, reporting that vision improvement is usually notable after adaptation. 37 Navel et al reported similar outcomes.…”

Section: Corneal Ectasia After Refractive Surgerymentioning

confidence: 99%

See 2 more Smart Citations

Evidence of Contact Lenses for Vision Rehabilitation in Corneal Diseases: A Review

Vilà Porsell,

Rodriguez Lopez,

Rocha-de-Lossada

et al. 2023

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Compression sutures alone to treat acute hydrops in a case of post-laser in situ keratomileusis ectasia and review of literature

Ahuja,

Gujar

2024

Indian Journal of Ophthalmology - Case Reports

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This is a case report of acute hydrops in a patient with post-laser in situ keratomileusis (LASIK) ectasia treated with compression sutures. A patient with post-LASIK ectasia presented with acute hydrops in the left eye. Full-thickness compression sutures were applied to appose the edges of the Descemet tear, and this resulted in a rapid resolution of stromal edema and interface fluid. The patient had the best distance visual acuity of 6/18 at the last follow-up. Compression sutures only were useful in this case to hasten the resolution of stromal edema and interface fluid.

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Scleral Lens Visual Rehabilitation of Sequential Bilateral Corneal Hydrops With Post-LASIK Ectasia

Cited by 4 publications

References 12 publications

Keratoconus: An updated review

Keratoconus: An updated review

Evidence of Contact Lenses for Vision Rehabilitation in Corneal Diseases: A Review

Compression sutures alone to treat acute hydrops in a case of post-laser in situ keratomileusis ectasia and review of literature

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