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A. Kolck, T. Buchner, H. Busse; Rigid Contact Lenses in Patients With Keratoconus and Irregular Astigmatism After Penetrating Corneal Injury. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5397.
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The aim was to test the efficiency of rigid gas-permeable contact lenses for complicated corneal pathologies.
The study included 20 patients with keratoconus and 4 patients with corneal scaring and irregular astigmatism after penetrating corneal injury who were fitted with rigid gas-permeable lenses between 2003 and 2006.
The majority of keratoconus patients (15/20) presented with an asymmetrical manifestation of the disease. Average age was 28 years (15-48). Best visual acuity with spectacles was on average 0.5 (1/35-1.0) compared with 0.8 ( 0.6-1.0) average visual acuity with rigid contact lenses. With contact lenses visual acuity increased in all cases, on average 3 lines. 26 eyes were fitted with 4 curve-corneal contact lenses. In 5 eyes individual concepts were developed. 5 eyes were fitted with aspherical contact lenses. Patients with irregular astigmatism after penetrating corneal injury were fitted with aspherical lenses (2/4), a bitoric lens (1/4) and a 3-curve miniscleral contact lens (1/4) combined with silicone-hydrogel contact lens (piggyback system). All 4 patients were aphacic and had corneal scaring in at least one quadrant of the cornea. Average visual acuity was 0.8 and contact lenses were well tolerated in all cases. Complications were confined to superficial keratopathy which in some cases made a modification of the contact lens necessary. In two cases a progression of keratoconus occurred during follow-up making a new fitting necessary. Fluorescein images and corneal topographies are presented.
Rigid gas-permeable contact lenses are very suitable for optical rehabilitation of patients with keratoconus or irregular astigmatism due to corneal scaring. Surgery can be postponed or even prevented. A longer follow-up is necessary.
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