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CONTACT LENSES FOR EXTREME ECTASIA- A COMPARATIVE ANALYSIS
JATIN ASHARMUMBAI EYE CARE CORNEA AND
LAISK CENTRE
• NO FINANCIAL DISCLOSURE
Contact Lens in Extreme Ectasia
• Old wine in a new bottle!
• Rose K - XL• Semi Scleral and Scleral CL• Hybrid CL
Topography Based Traditional CL Fitting Guide
Principle of Large Diameter Lenses
Vaulting Is The Key
Fitting CL in Extreme Ectasia
Case 1
• Fitted with Rose K XL
• Visual acuity with CL - 6/6 p
Case 1
Case 2
• Fitted with Europa Scleral CL
• Visual acuity - 6/9
Case 3
• Fitted with an hybrid contact lens
• Visual acuity- 6/9
Comparative Analysis- Which Lens Stands Out!
• Comparison of Rose K XL (14.2mm) / Hybrid CL (Clearkone, Synergeyes, USA) (14.5mm) / Semi Scleral 15.2 mm (Jupiter, USA), Scleral 18.2mm (Jupiter, USA) / Europa 16mm (USA)
• Parameters studied-– Visual outcome– Comfort– Chair time
• 24 cases of ectasia with Mean K > 60 D• 10 – Keratoconus• 6 – Pellucid Marginal Degeneration• 4 – Post LASIK • 4 - Post RK
• All cases were fitted with hybrid/ Rose K XL and Semi-scleral/ Scleral lenses sequentially
Results• Visual acuity improved in all from mean less than 0.1 to 0.9• For keratoconus all lenses fit equally well• For PMCD and Post LASIK/ RK – peripheral design
modification is needed for Rose K XL lenses- increasing chair time and increased number of trials
• Reverse geometry design of Europa and RG- Scleral contact lenses required minimal design modification and give excellent comfort
• E CL & H CL were most comfortable for patients• Subjective visual improvement - maximum with H CL
Conclusion
• Battle against the bulge doesn't always need a surgical knife
• All it needs is to mask it with an appropriate contact lens