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The role of scleral contact lenses in vision rehabilitation after intracorneal ring segment implantation

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First Author: A.Penbe TURKEY

Co Author(s):    A. Penbe   H. KANAR                 

Abstract Details

Purpose:

To assess the efficiency and safety of the scleral contact lens (SCL) wearing in the visual rehabilitation of keratoconus patients who have insufficient visual results after intracorneal ring segment (ICRS) implantation.

Setting:

Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul

Methods:

In this prospective study, between September 2017 and July 2019, 26 eyes of 17 patients with ICRS implantation and the best-corrected visual acuity (BCVA) was under 20/40 evaluated with Mini Misa SCL for correcting residual refractive errors. Contact lens corrected visual acuity (CLCVA), refractometry, keratometry, wavefront analyses of high order aberrations (HOAs) of all patients obtained from Sirius (CSO, Italy) corneal topography were measured before and after 6 hours of SCL wearing. The mean follow-up period was 15.25 ± 2.3 months (min-max: 8-21 months), and SCL-related adverse events were recorded.

Results:

All patients had improvement in visual acuity with SCL fitting. The initial BCVA was 0.68 ± 0.26 logMAR, CLCVA decreased to 0.15 ± 0.06 logMAR (p=0.024). The spheric equivalence, manifest astigmatism, the total corneal HOAs, astigmatism, coma, trefoil, and Optic path difference (OPD) coefficients in root mean square (RMS) decreased significantly (p0.05). By contrast, there was an increase in spherical aberrations associated with the base curve of SCL (p=0.031). 1 patient showed intolerance due to the irritation on the nasal pinguecula and the peripheral parameters of the SCL were rearranged. One patient dropped out due to handling problems.

Conclusions:

Scleral contact lenses are an effective and safe option for keratoconus patients who are unsatisfied because of the residual high and irregular refractive errors after ICRS implantation. A significant increase in visual acuity and a decrease in corneal aberrations can be obtained with SCL in most of the patients with irregular corneas.

Financial Disclosure:

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