Research progress of clinical application and complication of contact lens in keratoconus / 国际眼科杂志(Guoji Yanke Zazhi)

Keratoconus is a progressive blinding eye disease that characterized by corneal thinning and protrusion, which accompanied with irregular astigmatism and impaired visual acuity.The irregular astigmatism of early keratoconus can be corrected by spectacles. For the irregular astigmatism of moderate to severe keratoconus, spectacles are no longer suitable, and contact lenses are the best choice for patients to restore vision. There are various types of contact lenses, making the selection very difficult. In addition, trying on lenses for a long time will increase the discomfort and overall feeling of patients, and greatly increase the workload of doctors. Thus, the article aims to summarize and discuss the classification of contact lenses, the application of contact lenses in different types of keratoconus, the complications of contact lens, and the current status and prospect of contact lenses, with a view to understanding the management and clinical application of contact lenses in keratoconus patients and to further improving the application value of contact lenses in keratoconus.

Corneal Abscess on Mini-scleral Contact Lens: Clinical Case

Mini-scleral lens’ are large diameter rigid lenses that are used to rehabilitate vision when the corneal shape is distorted from disease, scarring or after a corneal graft procedure, however, there are relatively few reports regarding their potential complications, in this case we describe the case of a corneal abscess in a mini-scleral lens wearer with keratoconus in order to determine whether this type of contact lens presents an increased risk of infection.

Boston ocular surface prosthesis: An Indian experience.

Context: Boston ocular surface prosthesis (BOSP) is a scleral contact lens used in the management of patients who are rigid gas permeable (RGP) failures as with corneal ectasias such as keratoconus and in those patients who have ocular surface disease such as Stevens–Johnson syndrome (SJS). Aim: To report utilization of BOSP in a tertiary eye care center in India. Materials and Methods: We retrospectively reviewed charts of 32 patients who received BOSP from July 2008 to May 2009. Indications for fitting these lenses, improvement in visual acuity (VA) before and after lens fitting and relief of symptoms of pain and photophobia were noted. Paired t-test was used for statistical analysis using SPSS version 16.0 for Windows. Results: Thirty-two patients (43 eyes) received these lenses. These consisted of 23 eyes of 17 patients who failed RGP trials for irregular astigmatism and corneal ectasia such as keratoconus and post radial keratotomy and scar and 20 eyes of 15 patients with SJS. Mean age of RGP failures was 27.94 years. Pre- and post-BOSP wear mean LogMAR VA was 1.13 and 0.29, respectively, in RGP failures. The P value was statistically significant (P < 0.001). In patients with SJS, LogMAR VA was 0.84 ± 0.92 before and 0.56 ± 0.89 after lens wear. The P value was statistically significant (P < 0.001). VA improved by >2 lines in 7/20 eyes (35%) with SJS, with improvement in symptoms. Conclusion: BOSP improves VA in patients who have irregular astigmatism as in ectasias and RGP failures and improves vision and symptoms in patients with SJS.

Lentes de contacto rígidos gas permeables esclerales, una opción terapéutica en el tratamiento de enfermedades de la superficieocular / Rigid escleral gas permeable contact lenses, a therapeutic option in the ocular surface diseases treatment

Los lentes de contacto esclerales han mantenido un pequeño pero valioso lugar entre los lentes de contacto en la práctica clínica. Es evidente que, debido a la poca instrucción del lente escleral, no se le hadado una alta prioridad en el ámbito profesional, lo que conlleva a que muchos profesionales no tengan una comprensión de sus ventajas intrínsecas y, en consecuencia, rara vez se prescribe o recomienda su uso. Este tipo de lentes rígidos gas permeables desempeñan un papel importante y no se valoran suficientemente en el tratamiento de enfermedades corneales, así como su beneficio para la rehabilitación visual de ectasias, astigmatismos irregulares y en la terapia de la enfermedad de la superficie ocular.

Scleral contact lenses lenses have maintained a small but uniquely valuable place within the contact lenses in clinical practice. It is obvious that due to poorly educated scleral lens has not been given a high priority in the professional field which implies that many professionals do not have an understanding of their intrinsic merits and therefore rarely prescribedor recommended for use. This type of rigid gaspermeable lenses performs an important role and its underrated in the treatment of corneal diseases and their performance for the rehabilitation of visual ecstasies, irregular astigmatism, and therapy of disease of the ocular surface.