Management of subepithelial hypoplasia syndrome (SEH) in course of keratoconus

Poster Details

First Author: K.Trzciakowski POLAND

Co Author(s):    P. Jaworski   H. Wykrota           

Abstract Details

Purpose:

To assess advantages of the modern computer technique used for anterior segment imaging (PENTACAM) in RGP lenses fitting in patients with SEH secondary to keratoconus.

Setting:

In most cases of keratoconus, the effective way to correct refractive error is an application of rigid gas-permeable contact lenses. Unfortunately, in course of keratoconus, we can observe SEH syndrome, which requires some modifications in ways of contact lenses fitting. We are describing the problem of SEH in keratoconic eyes and discussing its treatment modalities and presenting new possibilities in fitting hard contact lenses, using modern techniques for anterior eye segment imaging (PENTACAM).

Methods:

We evaluate 34 eyes of 24 patients including 14 females (20 eyes) and 10 males (14 eyes) with visible SEH syndrome due to keratoconus. Control group consisted of 17 eyes of 14 patients including 8 females (9 eyes) and 6 males (8 eyes). Hecht lenses of keratoconical geometry KAKAC-F and KAKCF-PROG were fitted in all patients. The fitting was steep-bridge. Posterior corneal topography was made using PENTACAM Oculus device. Posterior corneal topography before lens fitting was compared after one hour of steep fitted lenses wear (second examination with lenses on the eye). Lenses geometry was changed in this way to achieve minimal changes in posterior corneal topography in the keratoconus area. In some eyes additional treatment by use of tissue glue was applied. Follow-up period was 12 months.

Results:

After 12 month we observed statistically significant better results in group in which we have applied RGP lenses fitted with help of PENTACAM examination in terms of normal epithelium recovery, SEH clear up, " proud nebula" prevalence, contact lens's tolerability.

Conclusions:

Technique used allowed to obtain information concerning lenses fitting, which has been unavailable in the traditional fitting procedure that allows to achieve better treatment results of SEH in long observation period. FINANCIAL DISCLOSURE?: No