Visual quality with corneo-scleral contact lenses after intracorneal ring segment (ICRS) implantation for keratoconus management

Purpose: To evaluate the visual quality results when fitting a corneo-scleral contact lens (CScL) after intracorneal ring segment (ICRS) implantation for keratoconus management. Methods: Twenty-seven eyes of 27 patients with keratoconus underwent ICRS implantation and had CScL fitted as their visual...

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Bibliographic Details
Authors: Montalt JC, Porcar E, España-Gregori E, Peris-Martínez C
Format: article
Status:Published version
Publication Date:2019
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p2544
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/2544
Access Level:Open access
Keyword:Corneal ectasia
Keratoconus
Corneoscleral contact lens
Intracorneal ring segment
Description
Summary:Purpose: To evaluate the visual quality results when fitting a corneo-scleral contact lens (CScL) after intracorneal ring segment (ICRS) implantation for keratoconus management. Methods: Twenty-seven eyes of 27 patients with keratoconus underwent ICRS implantation and had CScL fitted as their visual quality was unsatisfactory with their spectacles or contact lenses. Patients received a complete eye examination, refraction and visual acuity assessment, anterior eye biomicroscopy, ocular fundus examination, corneal topographic analysis, endothelial-cell count, and visual quality assessment using contrast sensitivity and aberrometry tests. A diagnostic trial set was used in the fitting process, and patients were assessed according to a standardised methodology, including subjective visual quality and comfort, and contact lens usage time. The follow-up period was one year. Results: After fitting CScL, log-MAR visual acuity values improved significantly in relation to the best spectacle-corrected vision (0.22 +/- 0.17 vs 0.00 +/- 0.12; p < 0.001). Total high-order aberrations decreased 33% (2.62 +/- 1.31 vs 1.75 +/- 1.81 pm; p < 0.009) and the spatial frequencies of contrast sensitivity all improved (all p < 0.05). Furthermore, 70.37% of patients reported high ratings of subjective visual quality (favourable and very favourable) and prolonged usage times (11.78 +/- 3.93 h). After wearing CScL for one year, no adverse ocular effects or clinically relevant changes in corneal parameters, visual quality, comfort ratings or usage time were found. Conclusion: This CScL appears to be an alternative reasonable option for keratoconic eyes with ICRS placement, providing an improvement in subjective visual quality.