Abdelkader Sidi Mohamed Hamida, García-Barchín Marta, Ruiz-Fortes Pedro, David P Piñero
{"title":"Characterization and prediction of the clinical result with a specific model of mini-scleral contact lens in corneas with keratoconus.","authors":"Abdelkader Sidi Mohamed Hamida, García-Barchín Marta, Ruiz-Fortes Pedro, David P Piñero","doi":"10.1186/s40662-022-00310-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To investigate which factors are correlated with the visual improvement achieved with a specific model of scleral contact lens (SCL) in keratoconus (KC) eyes and to define a model to predict such improvement according to the pre-fitting data. In addition, the changes occurred with the fitting of a specific model of SCL during a period of 3 months in corneas with KC have been investigated.</p><p><strong>Methods: </strong>Longitudinal retrospective study including 30 eyes of 18 patients (age, 14-65 years) with KC fitted with the SCL ICD16.50 (Paragon Vision Sciences). Visual, refractive, corneal tomographic and ocular aberrometric changes were evaluated during a 3-month follow-up. Likewise, the characterization of the post-lens meniscus was performed by optical coherence tomography (OCT) with the measurement of central, nasal and temporal vaults.</p><p><strong>Results: </strong>The visual acuity increased significantly from a mean pre-fitting value with spectacles of 0.23 ± 0.07 logarithm of minimal angle of resolution (logMAR) to a mean value of 0.10 ± 0.04 logMAR after 1 month of SCL wear (P < 0.001). An improvement of 1 or more lines of visual acuity with the SCL occurred in 62.1% of the eyes. A significant decrease in central, nasal, and temporal vault was observed after 1 month of SCL wear (P ≤ 0.046). Likewise, there was a significant difference between nasal and temporal vaults during the first month of SCL use (P = 0.008). Furthermore, a significant reduction of ocular high order (P = 0.028) and primary coma root mean square (P = 0.018) was found with the SCL. A predicting linear equation of the change in visual acuity achievable with the SCL was obtained (P < 0.001, R<sup>2</sup> = 0.878) considering the pre-fitting spectacle corrected distance visual acuity, and the power and sagittal lens of SCL.</p><p><strong>Conclusions: </strong>The scleral contact lens evaluated provides an efficacious visual rehabilitation in KC due to the improvement of visual acuity and the correction of low and high-order ocular aberrations. This visual acuity improvement can be predicted from some pre-fitting variables.</p>","PeriodicalId":520624,"journal":{"name":"Eye and vision (London, England)","volume":" ","pages":"39"},"PeriodicalIF":0.0000,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536044/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eye and vision (London, England)","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40662-022-00310-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: To investigate which factors are correlated with the visual improvement achieved with a specific model of scleral contact lens (SCL) in keratoconus (KC) eyes and to define a model to predict such improvement according to the pre-fitting data. In addition, the changes occurred with the fitting of a specific model of SCL during a period of 3 months in corneas with KC have been investigated.
Methods: Longitudinal retrospective study including 30 eyes of 18 patients (age, 14-65 years) with KC fitted with the SCL ICD16.50 (Paragon Vision Sciences). Visual, refractive, corneal tomographic and ocular aberrometric changes were evaluated during a 3-month follow-up. Likewise, the characterization of the post-lens meniscus was performed by optical coherence tomography (OCT) with the measurement of central, nasal and temporal vaults.
Results: The visual acuity increased significantly from a mean pre-fitting value with spectacles of 0.23 ± 0.07 logarithm of minimal angle of resolution (logMAR) to a mean value of 0.10 ± 0.04 logMAR after 1 month of SCL wear (P < 0.001). An improvement of 1 or more lines of visual acuity with the SCL occurred in 62.1% of the eyes. A significant decrease in central, nasal, and temporal vault was observed after 1 month of SCL wear (P ≤ 0.046). Likewise, there was a significant difference between nasal and temporal vaults during the first month of SCL use (P = 0.008). Furthermore, a significant reduction of ocular high order (P = 0.028) and primary coma root mean square (P = 0.018) was found with the SCL. A predicting linear equation of the change in visual acuity achievable with the SCL was obtained (P < 0.001, R2 = 0.878) considering the pre-fitting spectacle corrected distance visual acuity, and the power and sagittal lens of SCL.
Conclusions: The scleral contact lens evaluated provides an efficacious visual rehabilitation in KC due to the improvement of visual acuity and the correction of low and high-order ocular aberrations. This visual acuity improvement can be predicted from some pre-fitting variables.