First Experience With the ICD 16.5 Mini-Scleral Lens for Optic and Therapeutic Purposes.

OBJECTIVES: To evaluate the success rate, efficacy, and safety of the ICD 16.5 mini-scleral gas permeable (GP) contact lens. METHODS: This prospective study included referred consecutive patients with irregular corneas and severe ocular surface disease (OSD) in treatment failure. All patients were fitted with the ICD 16.5 mini-scleral GP lens. Even though we had some limited experience with scleral lenses, it was our first experience with the ICD 16.5 mini-scleral GP lens. Efficacy was assessed by comparing best-corrected visual acuity (BCVA) with the mini-scleral lens to baseline BCVA. A subjective visual functioning questionnaire (comfort score, visual quality score, handling rating, and wearing time) was administered in a face-to-face structured interview. RESULTS: Thirty-nine eyes of 23 patients with a mean age of 43±16 years were included. Fitting indications were keratoconus (46%), post-penetrating keratoplasty (21%), other irregular astigmatism (15%), and severe OSD (18%). Twenty-five eyes (64%) were successfully fitted with an 18-month follow-up. The mini-scleral GP lens BCVA was 0.16 logarithm of the minimum angle of resolution (logMAR; 20/25) versus a baseline BCVA of 0.44 logMAR (20/63; P<0.001). Comfort and visual quality scores were 8.5/10 and 7.5/10, respectively. No complications were detected in 96% of the eyes (95% confidence interval, 76.1%-99.4%). One eye experienced corneal graft swelling. CONCLUSIONS: The present findings suggest that the ICD 16.5 mini-scleral GP lens is an effective and safe alternative for managing challenging corneas in a therapeutic impasse.

Retrospective case series of therapeutic applications of a lotrafilcon A silicone hydrogel soft contact lens.

PURPOSE: To report a series of consecutive cases for which a lotrafilcon A silicone hydrogel soft contact lens was used in therapeutic applications. METHODS: Three practitioners in Spain, Denmark, and Germany supplied 41 consecutive case reports on 39 patients for whom a lotrafilcon A silicone hydrogel soft contact lens was used in therapeutic applications for erosion or recurrent erosion, bullous keratopathy, corneal edema, corneal dystrophy, neurotrophic corneal ulcer, entropion, and after corneal surgeries. Practitioners reported their judgements of pain relief, change in corneal signs by slitlamp evaluation, additional complications, and success of therapeutic lens treatment. Twenty cases that had completed treatment and 21 that remained under ongoing treatment were reported. RESULTS: Complete pain relief was reported for 78% of cases with 94% reporting pain relief of 50% or more. Corneal signs were restored to normal for 74% of cases with 100% showing at least partial improvement. No additional complications were reported in 83% of cases. Therapeutic contact lens application was judged fully successful for 71% of cases with 93% showing at least partial success. CONCLUSION: The high-Dk lotrafilcon A lens met or exceeded the outcomes reported from historic reports of therapeutic applications of low-Dk soft contact lenses. Whereas the case reporting conditions may vary among the historic studies and from the current study, there is the indication that success may be improved with the lotrafilcon A high-Dk lens.

Retrospective case series of therapeutic applications of lotrafilcon a silicone hydrogel soft contact lenses.

PURPOSE: To report a series of consecutive cases for which a lotrafilcon A silicone hydrogel soft contact lens was used in therapeutic applications. METHODS: Three practitioners in Spain, Denmark, and Germany supplied 41 consecutive case reports of 39 patients for whom a lotrafilcon A silicone hydrogel soft contact lens was used in therapeutic applications. Applications included erosion or recurrent erosion, bullous keratopathy, corneal edema, corneal dystrophy, neurotrophic corneal ulcer, entropion, and use after corneal surgeries. Practitioners reported their judgments of pain relief, change in corneal signs by slitlamp evaluation, additional complications, and success of therapeutic lens treatment. Twenty cases of completed treatment and 21 cases of ongoing treatment were reported. RESULTS: Complete pain relief was reported for 78% of all cases, with 94% of all cases reporting pain relief of 50% or higher. Corneal signs were restored to normal for 74% of all cases, with 100% of all cases showing at least partial improvement. No additional complications were reported in 83% of all cases. Therapeutic contact lens application was judged fully successful for 71% of all cases, with 93% of all cases showing at least partial improvement. CONCLUSION: The high-oxygen permeable (Dk) lotrafilcon A lens met or exceeded the outcomes reported from historic reports of therapeutic applications of low-Dk soft contact lenses. Although the case reporting conditions vary among the historic studies and from the current study, this study indicates that success may be improved with the lotrafilcon A high-Dk lens.