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Angela Shin, Clark Chang, Kristen Fry, Peter Hersh; The Use of Hybrid Contact Lenses in Keratoconus and Ectasia Patients Post-Intacs and Collagen Crosslinking. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4726.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate performance of hybrid lenses (ClearKone, SynergEyes, Inc.) in keratoconus (KC) or ectasia patients post-Intacs or post-Intacs/corneal collagen crosslinking (CXL).
A retrospective consecutive chart review was performed on 18 KC (N=14) and ectasia (N=4) patients after Intacs (N=3) or Intacs/CXL (N=15) who were fitted with Clearkone hybrid contact lenses. Success was defined as eyes regularly wearing lenses 3-months post final lens fitting. Relationships of corneal topographic parameters and KC severity to lens success were evaluated. Final management methods for eyes unsuccessful with these hybrid lenses were also analyzed.
Mean age of the study cohort was 33 yrs (22-52 yrs) with 7 females and 11 males. Mean steep keratometry was 50.93D (±5.82) for all eyes; 22.2% (4/18), 33.3% (6/18), 00.0% (0/100), 44.4% (8/18) were diagnosed stages 1, 2, 3 and 4 respectively using the Amsler-Krumeich keratoconus classification. 77.8% of eyes (14/18) succeeded with the study lenses. Mean logMAR VA was -0.33 with habitual correction and improved to -0.14 with the lenses. Of the successful eyes, mean VA increased by 1.64 lines while 44.4% (8/18) gained 2 or more lines. The main reason cited by the 5/14 eyes (35.7%) for continuing lens wear, despite no improvement in VA from previous lens modalities was improved comfort.Subsequently, of the 22.2% (4/18) unsuccessful with this lens, fitting success was acheived with RGP (N=2), scleral lens (N=1), and custom soft toric (N=1). A learning curve effect may have contributed to the failure of these hybrid lenses in the 4 post-Intacs/CXL eyes as these were the first 4 eyes fit in this retrospective review; success was otherwise reached in all 14 eyes thereafter. The main reason cited for discontinuing contact lens wear was difficulty with insertion and removal (75%).Corneal topography, corneal astigmatism, refractive spherical equivalence and cylinder (when available), did not correlate with success rates.
Post-Intacs and post-Intacs/CXL KC and ectasia eyes achieve a high success rate with Clearkone hybrid contact lenses. Improved lens wear comfort and good ability with lens insertion and removal appears to be important factors in achieving successful fitting outcome.
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