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High Astigmatism Secondary to Peripheral Ectasia Recurrence in Postpenetrating Keratoplasty Eyes Managed With Miniscleral Contact Lenses.
- Source :
-
Eye & contact lens [Eye Contact Lens] 2023 Oct 01; Vol. 49 (10), pp. 417-421. Date of Electronic Publication: 2023 Aug 18. - Publication Year :
- 2023
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Abstract
- Objectives: After penetrating keratoplasty (PK) for keratoconus, vision can be impaired by high-degree astigmatism, particularly in those patients with recurrent peripheral ectasia. Scleral contact lenses (CLs) have long been used in the management of keratoconus both in treatment-naive corneas and those postcorneal transplants. We report the use of miniscleral CLs and their related visual and clinical outcomes in a series of patients with post-PK peripheral rim ectasia.<br />Methods: In this retrospective case series, 5 patients (7 eyes) presented because of reduced visual acuity with their spectacles/CLs and/or reduced comfort with their existing rigid gas-permeable lenses. All patients in this series underwent PK more than two decades ago for keratoconus (mean 28.7 years±7.2). All patients demonstrated characteristic thinning at the graft-host junction, with anterior chamber deepening. Central corneas had remained clear in all patients inferring high visual potential. Contact lenses used were No 7 Comfort 15 miniscleral and the Onefit MED scleral with 14.5 mm and 15.6 mm diameters, respectively.<br />Results: All eyes achieved a best-corrected visual acuity of 6/9 or greater. One case had difficulty with insertion and removal and has since discontinued wearing lens at this time. All others are successfully wearing the lenses regularly.<br />Conclusion: Despite advances in CL design, surgical management is still required in some patients. Miniscleral CLs are effective in the refractive management of peripheral ectasia in keratoconic post-PK eyes and should be considered in such eyes before proceeding with repeat surgical intervention.<br />Competing Interests: I. Sexton is a professional services manager for No 7 contact lenses advising practitioners on complex contact lens fitting. The remaining authors have no funding or conflicts of interest to disclose.<br /> (Copyright © 2023 Contact Lens Association of Ophthalmologists.)
- Subjects :
- Humans
Retrospective Studies
Dilatation, Pathologic etiology
Dilatation, Pathologic surgery
Visual Acuity
Keratoplasty, Penetrating adverse effects
Keratoconus surgery
Keratoconus complications
Astigmatism etiology
Astigmatism surgery
Corneal Transplantation adverse effects
Contact Lenses adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1542-233X
- Volume :
- 49
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Eye & contact lens
- Publication Type :
- Academic Journal
- Accession number :
- 37595277
- Full Text :
- https://doi.org/10.1097/ICL.0000000000001022