Posters

Nonsurgical procedures for keratoconus management: scleral and hybrid lenses

Poster Details

First Author: S.Kocabeyoglu TURKEY

Co Author(s):    O. Dikmetas   M. Irkec                 

Abstract Details

Purpose:

In mild to moderate keratoconus, soft and rigid gas permeable (RGP) lenses may help to improve vision, but as the conicity of cornea increases, these lenses do not improve vision and patients may have to use other lenses such as piggyback contact lenses, hybrid lenses, and scleral contact lenses (ScCL). In this sudy we evaluated corneal cell morphology and clinical findings in patients with moderate keratoconus, treated with ScCL or hybrid lenses using an in vivo slit scanning confocal microscope (IVCM).

Setting:

Hacettepe University School of Medicine.

Methods:

A total of 57 eyes with moderate keratoconus were included. Twenty postcorneal graft patients, who had astigmatism more than 4 D after suture removal (at the end of 1 year), and whose visual acuities were insufficiently corrected with spectacles were evaluated. Ten patients had been prescribed hybrid lenses and ten patients had been prescribed ScCL. Thirtyseven patients who had severe KC had indication for keratoplasty but these patients did not want to undergo surgery, so we prescribed ScCL/hybrid CL (5 patients and 32 patients). Corneal endothelium was analyzed using IVCM. Mann-Whitney U and Wilcoxon tests were used for statistical analysis.

Results:

Fifteen eyes of the 15 clinically diagnosed patients with keratoconus treated with ScCL (11 M; 4 F) and 42 eyes treated with hybrid CL (18 M; 24F) were evaluated. The mean interval time contact lens fitting was 8.47 ± 2.85 months and 8.93±2.46 months  for ScCL and hybrid CL (P=0.454). In the ScCL group, average changes of endothelium cell density from 2408.9±203.2 to 2372.8±192.4 in the hybrid CL group from 2580.5±289.4 to 2517.12±285.95 (P = 0.044 for ScCL, P<0.001 for hybrid CL). A significant improvement in the mean uncorrected visual acuity was found in both groups.

Conclusions:

The use of contact lenses in KC management provides the best visual rehabilitation and improves patients' quality of life. In selected cases those who require some surgical option but do not achieve good visual acuity, lenses are a good alternative to improve visual acuity.

Financial Disclosure:

None