Scleral Lenses Reduce the Need for Corneal Transplants in Severe Keratoconus

Autor: Louise Vermeulen, Lieselotte Anthonissen, Elke O. Kreps, Carina Koppen, Sorcha Ní Dhubhghaill, Maarten Van Hoey
Přispěvatelé: Ophtalmology - Eye surgery
Rok vydání: 2017
Předmět:
Male
Visual acuity
Time Factors
genetic structures
Scheimpflug principle
Visual Acuity
Keratoconus/diagnosis
Severity of Illness Index
law.invention
0302 clinical medicine
law
Refraction
Ocular/physiology
Keratoplasty
Penetrating/methods
Dioptre
education.field_of_study
medicine.diagnostic_test
Equipment Design
Middle Aged
Corneal topography
Lens (optics)
Treatment Outcome
Female
medicine.symptom
Sclera
Adult
medicine.medical_specialty
Keratoconus
Contact Lenses
Population
Refraction
Ocular
03 medical and health sciences
Scleral lens
Ophthalmology
medicine
Humans
education
Retrospective Studies
business.industry
Corneal Topography
medicine.disease
eye diseases
030221 ophthalmology & optometry
Optometry
Human medicine
sense organs
business
030217 neurology & neurosurgery
Keratoplasty
Penetrating
Follow-Up Studies
Zdroj: American journal of ophthalmology
ISSN: 1879-1891
0002-9394
Popis: PURPOSE: To investigate the success and failure rates of scleral lens correction in severe keratoconus. DESIGN: Retrospective case series. METHODS: Study population comprised patients with keratoconus who attended the keratoconus clinic at the Antwerp University Hospital, Belgium, between January 1, 2010, and December 31, 2014. The included eyes had maximal keratometry values >= 70 diopters, as measured using the sagittal curvature map that was obtained by Scheimpflug tomography. The exclusion criteria included amblyopia, mental retardation, and concomitant ocular disease that limited their visual potential. RESULTS: Scleral lens fitting was proposed for the 75 eyes included in the study. Eight eyes underwent transplant surgery because of insufficient visual acuity with the lenses, lens intolerance, and issues with handling the lenses. Twelve eyes did not have lenses fitted because of good visual acuity in the other eye or a contraindication for lens wear. Three eyes were successfully fitted with corneal or hybrid lens wear. Scleral lenses were prescribed in 51 of 75 eyes. The mean gain in visual acuity (lens vs spectacle-corrected visual acuity) was 0.54 0.18 (decimal fraction, Snellen eye chart). Seven eyes were lost to follow-up, 4 eyes abandoned wearing the scleral lens because of an inability to handle the lenses, and 40 eyes wore the lenses at their last follow-up visit, with a mean follow-up interval of 30.15 +/- 12.83 months. CONCLUSIONS: Forty of the 51 eyes with severe keratoconus that would otherwise have undergone transplant surgery were successfully treated with long-term scleral lens wear. In this way, the indication for keratoplasty was more than halved in our keratoconus population. (C) 2017 Elsevier Inc. All rights reserved.
Databáze: OpenAIRE
Externí odkaz: