Posters

Managing post-surgical cornea with advanced contact lenses: large diameter corneal rigid, corneo-scleral, mini-scleral and scleral, hybrid and thick soft lenses

Poster Details

First Author: S. Peixoto-de-Matos PORTUGAL

Co Author(s):    R. Macedo-de-Araujo   J. Gonzalez-Meijome                 

Abstract Details

Purpose:

To review the indications, options efficacy and safety of the application of different contact lenses for application in the post-surgical cornea and to present the results of our lab on the prescription of these lenses.

Setting:

CEORLab - Center of Physics, University of Minho, Braga, Portugal.

Methods:

Patients with post-LASIK irregular cornea, post-keratoplasty, with intra-corneal ring segments, and cross-linking were fitted with different types of contact lenses including but not limited to: large diameter rigid gas permeable corneal rigid, corneo-scleral, mini-scleral and scleral, hybrid and thick soft contact lenses. Fitting protocols recommended by the manufacturers were followed to achieve successful results in terms of central vault, limbal protection, scleral bearing, centration and comfort standards. When required macro-molecular fluorescein was used to fit the lenses.

Results:

Conventional and reverse geometry large diameter corneal lenses and corneo-scleral lenses were fitted in cases of mild corneal irregularity, thick soft contact lenses were preferred to avoid corneal trauma if a mild to moderate irregularity existed and satisfactory visual acuity was obtained; hybrid lenses were successful fit in cases of mild secondary ectasia and severe corneal irregularity as a result of LASIK procedures, mini-scleral lenses were preferred in cases of mild to moderate distortion of the ocular surface and after intra-corneal ring segment implantation with severe residual astigmatism, and full-scleral lenses were preferred in post-penetrating keratoplasty to save the highly distorted cornea from the contact with the lens.

Conclusions:

An algorithm of decision is provided to decide which lens to apply in each case depending on the primary indication, the architecture of the ocular surface as a result of the surgical procedure, the topographical corneal irregularity and the visual deficit associated with it, patients tolerance and visual demands.

Financial Disclosure:

NONE