Juan Carlos Montalt1, Esteban Porcar2, Enrique España-Gregori3, Cristina Peris-Martínez4. 1. Department of Optics, Optometry and Vision Sciences, Physics College, University of Valencia, Burjassot, Valencia 46100, Spain. 2. Department of Optics, Optometry and Vision Sciences, Physics College, University of Valencia, Burjassot, Valencia 46100, Spain. Electronic address: esteban.porcar@uv.es. 3. Department of Surgery, Ophthalmology Unit, la Fe University and Polytechnic Hospital, Faculty of Medicine and Odontology, University of Valencia, Hospital la Fe, Valencia 46026, Spain. 4. FISABIO Oftalmología Médica (FOM), Cornea Unit and Anterior Segment Diseases, Catholic University of Valencia, Valencia 46015, Spain.
Abstract
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 μm; 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.
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 μm; 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.