Feasibility of custom-made hydrogel contact lenses in keratoconus with previous implantation of intracorneal ring segments

Abstract

Purpose: To analyze the feasibility of a custom-made hydrogel silicone contact lens (CL) in keratoconus with intracorneal ring segments (ICRS) and to compare outcomes taking in consideration the geometry of the fitted lens-full periphery (FP) vs. sector management control (SMC).

Method: A retrospective review of cases with previous KeraRings ICRS implantation and subsequently fitted with Kerasoft-IC CL was performed. The main outcome measurements were corrected spectacle distance visual acuity (CDVA), differences between flat and steep simulated keratometries (K-diff) and between steep and flat P values (CPV-diff), CL visual acuity (CLVA), wearing time (WT) and complications associated with wear.

Results: Thirty eyes of 22 patients and a follow-up time of 10.3±2.3 months were reviewed. Statistically significant improvement was observed between LogMAR CDVA and CLVA (0.25±0.19 vs. 0.04±0.05; P<0.0001). WT was 11.2h±1.2. Two eyes with mild corneal staining and another two with mild injection were noted. Twenty SMC designs were recorded and associated with lower levels of CDVA (0.36±0.22 vs. 0.18±0.10; P=0.006), CLVA (0.06±0.05 vs. 0.01±0.03; P=0.03), and larger amounts of CPV-diff (2.31±1.86 vs. 1.03±1.11; P=0.02) than those eyes fitted with FP designs. No statistical differences were found in the amount of K-diff and WT between both sub-groups.

Conclusions: Fitting custom-made hydrogel silicone CL in keratoconus with ICRS is a feasible treatment with low rate of complications and adequate visual acuity and WT.

Keywords: Ferrara; Intracorneal rings; Irregular astigmatism; KeraRings; Keratoconus; Silicone hydrogel contact lenses.