Visual rehabilitation with scleral contact lenses in patients with irregular astigmatism

Autores/as

DOI:

https://doi.org/10.52379/mcs.v8i2.360

Palabras clave:

astigmatismo, lentes de contacto esclerales, rehabilitación visual

Resumen

Introduction: Scleral contact lenses (SCLs) are gas-permeable and are placed entirely on the sclera without contacting structures such as the cornea or limbus. These ECLs are designed to rehabilitate reduced vision of eyes with irregular corneas. Irregular astigmatism caused by corneal pathologies such as keratoconus, post-transplant, post-refractive surgery, or corneal degeneration produces poor visual acuity that cannot be corrected with air lenses, and the appearance of scleral contact lenses could be a therapeutic option in the treatment and optical correction of corneal pathologies. To determine the degree of improvement in visual acuity with adaptation of scleral lenses. Methodology: This was an observational, descriptive, retrospective, cross-sectional, retrospective study. Results: Forty cases of irregular astigmatism with different initial visual acuity effects were observed prior to the fitting of Scleral Lenses. The mean visual acuity (VA) prior to correction with scleral lenses observed in the 40 cases was 20/200 with correction on the Snellen scale with a minimum (worst VA) equal to "finger-count vision" (represented as cases with 20/ 400 vision for quantification purposes) and a maximum (best VA) of 20/70. Nineteen cases (47.5%) restored their VA to normal values (20/20), and 30 cases (75%) improved their VA by at least 10-fold from the baseline. Discussion: In this study, a remarkable and constant improvement in visual acuity was observed in all the patients. Some patients experienced an increase of up to 20 times their initial visual acuity, achieving, in many cases, a visual acuity of 20/20 on the Snellen scale. These results indicate a promising treatment strategy with fewer adverse effects.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Gurnani B, Kaur K. Astigmatism. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Oct 10]. URL

Ueno Y, Nomura R, Hiraoka T, Kinoshita K, Ohara M, Oshika T. Comparison of corneal irregular astigmatism by the type of corneal regular astigmatism. Sci Rep 2021;11(1):15769. https://doi.org/10.1038/s41598-021-95358-z

Schiefer U, Kraus C, Baumbach P, Ungewiß J, Michels R. Refractive errors. dtsch Arzteblatt Int 2016;113(41):693–702. https://doi.org/10.3238/arztebl.2016.0693

Deshmukh R, Ong ZZ, Rampat R, Alió del Barrio JL, Barua A, Ang M, et al. Management of keratoconus: an updated review. Front Med. 2023;10. https://doi.org/10.3389/fmed.2023.1212314

Arnalich-Montiel F, Alió del Barrio JL, Alió JL. Corneal surgery in keratoconus: which type, which technique, which outcomes? Eye Vis. 2016;3(1):2. https://doi.org/10.1186/s40662-016-0033-y

Harthan JS, Shorter E. Therapeutic uses of scleral contact lenses for ocular surface disease: patient selection and special considerations. Clin Optom. 2018;10:65–74. https://doi.org/10.2147/opto.s144357

Quitián AE. Scleral lenses in ectasia and irregular astigmatism after incisional refractive surgery and LASIK. Cienc Tecnol For Health Vis Ocul. 2010;8(2):51–61. http://dx.doi.org/10.19052/sv.822

Mariño Hidalgo O, Guerra Almaguer M, Cárdenas Díaz T, Pérez Suárez RG, del Carmen Medina Y, Milanés Camejo R. Scleral lenses: characteristics and indications. Rev Cuba Oftalmol. 2017;30(1):0–0. URL

Bromley JG, Randleman JB. Treatment strategies for corneal ectasia. Curr Opinion Ophthalmol. 2010;21(4):255-8. https://doi.org/10.1097/icu.0b013e32833a8bfe

Visser ES, Van der Linden BJJJ, Otten HM, Van der Lelij A, Visser R. Medical applications and outcomes of bitangential scleral lenses. Optom Vis Sci Off Publ Am Acad Optom. 2013;90(10):1078–85. https://doi.org/10.1097/opx.0000000000000018

Shorter E, Harthan J, Nau CB, Nau A, Barr JT, Hodge DO, et al. Scleral Lenses in the Management of Corneal Irregularity and Ocular Surface Disease. Eye Contact Lenses. 2018;44(6):372–8. http://dx.doi.org/10.1097/ICL.0000000000000436

Pullum KW, Whiting MA, Buckley RJ. Scleral contact lenses: the expanding role. Cornea. 2005;24(3):269–77. http://dx.doi.org/10.1097/01.ico.0000148311.94180.6b

Lee KE, Moon SY, Nam S, Jang JH, Kim JY, Tchah H, et al. Scleral Lens Applications Focused on Korean Patients with Various Corneal Disorders. Korean J Ophthalmol KJO. 2023;37(2):157–65. http://dx.doi.org/10.3341/kjo.2022.0164

Ozek D, Kemer OE, Altiaylik P. Visual performance of scleral lenses and their impact on quality of life in patients with irregular corneas. Arq Bras Oftalmol. 2018;81(6):475–80. http://dx.doi.org/10.5935/0004-2749.20180089

Walker MK, Bergmanson JP, Miller WL, Marsack JD, Johnson LA. Complications and fitting challenges associated with scleral contact lenses: A review. Contact Lens Anterior Eye J Br Contact Lens Assoc. 2016;39(2):88–96. http://dx.doi.org/10.1016/j.clae.2015.08.003

Ibrahim NK, Seraj H, Khan R, Baabdullah M, Reda L. Prevalence, habits and outcomes of using contact lenses among medical students. Pak J Med Sci. 2018;34(6):1429–34. http://dx.doi.org/10.12669/pjms.346.16260

Oshika T, Klyce SD, Applegate RA, Howland HC. Changes in corneal wavefront aberrations with aging. Invest Ophthalmol Vis Sci. 1999 Jun;40(7):1351–5. URL

Oie Y, Yasukura Y, Nishida N, Koh S, Kawasaki R, Maeda N, et al. Fourier Analysis on Regular and Irregular Astigmatism of Anterior and Posterior Corneal Surfaces in Fuchs Endothelial Corneal Dystrophy. Am J Ophthalmol. 2021;223:33–41. http://dx.doi.org/10.1016/j.ajo.2020.09.045

Kemraz D, Cheng XY, Shao X, Zhou KJ, Pan AP, Lu F, et al. Age-Related Changes in Corneal Spherical Aberration. J Refract Surg Thorofare NJ 1995. 2018;34(11):760–7. http://dx.doi.org/10.3928/1081597x-20181011-01

Descargas

Publicado

14-05-2024

Número

Sección

Artículos Originales

Artículos similares

<< < 1 2 

También puede {advancedSearchLink} para este artículo.