Success of Rigid Gas Permeable Contact Lens Fitting

Abstract

Following a standardized CLs fitting protocol, a relatively high percentage of successful GP fits was achieved for refractive (7/10 subjects) and therapeutic (9/10 subjects) prescriptions. These results will improve the information available to patients and aid in their CL choices by providing them with a realistic attitude. It will also help eye care practitioners in their clinical activities by providing evidence-based information.

BCLA CLEAR - Evidence-based contact lens practice

“…Advise rigid corneal or reverse geometry lenses when corneal irregularities are present RIGID CORNEAL: ↑ VA, ↓ higher-order aberrations [230], ↓ corneal irregularities, ↓ anisometropia for refractive error correction [231] Consider ScCL or hybrid with particularly severe corneal irregularities [182,223,232] Post keratoplasty or crosslinking (CXL) SOFT: Extend use of therapeutic bandage lens if prolonged ↓ epithelial healing [233] Consider SiHy overnight wear bandage, reverse geometry hydrogel or hydrogel toric lenses [238] Advise rigid corneal or reverse geometry lenses post keratoplasty Optical designs for irregular astigmatism (see Keratoconus) [233] RIGID CORNEAL: ↑ VA after CXL [234] Advise rigid corneal lens after CXL ↑ VA and good tolerance in post keratoplasty with (large diameter) rigid corneal lenses [235,236] ↑ VA and good tolerance in post keratoplasty with reverse-geometry lenses [237] Consider ScCL or hybrid in advanced stages [182,239] Seasonal allergy SOFT: Antigens bind to biofilm, ↑ signs and symptoms [58,240] Advise DD Provide greater tolerance to giant papillary conjunctivitis compared to soft lenses [276]. Consider ScCL in advanced atopic keratoconjunctivitis [182,241] ↑ Comfort and ↓ symptoms in allergic conjunctivitis (AC) with hydrogel DD [57,58] Consider hydrogel material in atopic keratoconjunctivitis [260,261].…”

“…Moderate to severe dry eye signs and symptoms SOFT: ↑ Tear stability with bandage lens [275]. Consider SiHy overnight wear bandage lens for severe DED Provide greater tolerance compared to soft lenses [276]. Advise ScCL in moderate to severe dry eye disease [223] ↑ Ocular surface staining after 6 months SiHy CL wear [24,54] CL contact lens, DD daily disposable, ScCL scleral contact lens, CLPC contact lens-induced papillary conjunctivitis, MSE mean spherical equivalent, CD centre distance, SiHy silicone hydrogel, DED dry eye disease, VA visual acuity, MK microbial keratitis.…”

General pain perception sensitivity, lid margin sensitivity and gas permeable contact lens comfort

“…3,4 Furthermore, it has been proposed that the use of demographic, historical and ocular information obtained during the initial examination may help clinicians improve their selection of prospective RGP wearers. 5,6 In spite of these measures and helpful information about practitioner and patient behaviour, the predictability of a successful RGP CL wearer remains challenging, which may contribute significantly to the lack in popularity of RGP corneal CLs 7 the percentage of RGP lenses worldwide is reported to be less than 11 per cent of the CL population over the past decade. 8 Similar to what has been observed in skin touch sensitivity when a repeated stimulus is applied, 9 the sensitivity of the cornea as well as touch sensitivity of the lid margin, reduces in RGP CL wear, [10][11][12][13][14] and this has been proposed to occur due to sensory mechanical adaptation.…”

“…Furthermore, it has been proposed that the use of demographic, historical and ocular information obtained during the initial examination may help clinicians improve their selection of prospective RGP wearers 5,6 . In spite of these measures and helpful information about practitioner and patient behaviour, the predictability of a successful RGP CL wearer remains challenging, which may contribute significantly to the lack in popularity of RGP corneal CLs2010 the percentage of RGP lenses worldwide is reported to be less than 11 per cent of the CL population over the past decade 2013…”

Fitting Gas Permeable Contact Lens in Keratoconus; Still a Challenge?

“…This new tool will allow that keratoconus patients receive the most adequate lens and help CL practitioners to provide a sound fitting process, decreasing the number of diagnostic lenses, trials, and chair time to those achieved in standard GP CL fitting. 23 Therefore with this new tool, keratoconus management with GP CL will be not a challenge any more; and both, patients and practitioners, will be benefited.…”