Clinical evaluation of different types of contact lenses in keratoconus management |
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| Affiliation: | 1. Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands;2. Visser Contact Lens Practice, Nijmegen, The Netherlands;3. Zonnestraal Eye Hospital Amersfoort, Amersfoort, The Netherlands;1. Department of Optics II (Optometry and Vision), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain;2. Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Spain;3. Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante, Spain;4. Department of Ophthalmology and Visual Science, University of Michigan, Northville, MI, USA;5. Ocupharm Group Research, Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain;1. Department of Ophthalmology, Servergazi State Hospital, Denizli, Turkey;2. Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey;1. Contact Lens Services, Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India;2. Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India;3. Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India |
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| Abstract: | PurposeTo compare the clinical and topographical findings of the keratoconus patients according to the prescribed contact lens type and to investigate the effects of corneal collagen cross-linking (CXL) and cone location on lens selection.MethodsThe records of 301 eyes of 195 keratoconus patients who were prescribed contact lenses were analyzed retrospectively. The eyes were grouped according to the lens type: Soft toric contact lens (STCL), rigid gas-permeable contact lens (RGPCL), hybrid contact lens (HCL) and mini-scleral contact lens (MSCL). The history of having CXL, ophthalmological examination findings, and the topographical findings were compared between the groups. Brown-Forsythe, Chi-square, and post-hoc tests were used to compare the groups. Mann-Whitney U test was used for subgroup analysis. Comparison of the lens-corrected visual acuity (LCVA) and spectacle-corrected visual acuity (SCVA) levels was made with Wilcoxon signed-ranks test.ResultsThere was no significant difference between the groups regarding topographical cone location, CXL history, spherical refraction, and LCVA. The difference between spectacle-corrected visual acuity and LCVA was higher in RGPCL and MSCL groups than STCL group (p=0.01). Keratometry of RGPCL and MSCL groups were higher than STCL and HCL groups (p=0.01, p<0.001). In RGPCL group, eyes with central cones had a higher increase in visual acuity with contact lenses compared to eyes with paracentral cones (p=0.043). STCL and MSCL were mostly prescribed in mild and severe keratoconic eyes, respectively. In RGPCL group, the increase in visual acuity with contact lens was higher in eyes treated with CXL (p= <0.01).ConclusionsWhile STCL and HCL were mostly prescribed in mild keratoconus, RGPCL and MSCL were selected for moderate or advanced disease. If appropriately chosen, all types of contact lenses could result in a good visual acuity level. CXL history did not affect the prescribed lens type. Having central cone location and CXL history in RGPCL group improved visual acuity more efficiently. |
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| Keywords: | Contact lens Cross-linking Keratoconus |
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