contact lenses for extreme ectasia- a comparative analysis jatin ashar mumbai eye care cornea and...

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