Optometry (St. Louis, Mo.) · 2004
Contact lens fitting over intrastromal corneal rings in a keratoconic patient.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hladun Larisia, Harris Michael
Аннотация
BACKGROUND: Intrastromal corneal ring segments have been used as a refractive surgery method for treatment of myopia. More recently, attempts have been made to use this surgical procedure in patients with keratoconus.
CASE REPORT: A 51-year-old man with keratoconus came to the clinic for a contact lens refit. He had undergone surgical insertion of intrastromal corneal rings in his right eye 7 months earlier in an attempt to obtain acceptable vision without contact lenses. At the time of presentation, the patient was not satisfied with his vision in the right eye and requested an attempt to improve his vision with a contact lens. The resulting corneal shape after surgery presented some complications, but the patient was able to achieve 20/25-vision and adequate comfort in his right eye with a piggyback contact lens system.
CONCLUSIONS: Insertion of intrastromal corneal rings may be beneficial in patients with early keratoconus or who are contact lens-intolerant. However, patients with more-advanced keratoconus are not likely to achieve adequate vision after the surgery and will require a contact lens. In addition, changes in the corneal anatomy created by the intrastromal rings may make contact lens fitting more challenging. The corneal irregularity may be exacerbated due to drastic variations in corneal elevation over the intrastromal ring and directly adjacent to the ring. This irregularity in elevation leads to difficulty in centering the lens on the eye and problems with bubbles forming under the contact lens over areas of corneal depression. When successfully fitted, contact lenses over intrastromal corneal rings can improve vision significantly.
CASE REPORT: A 51-year-old man with keratoconus came to the clinic for a contact lens refit. He had undergone surgical insertion of intrastromal corneal rings in his right eye 7 months earlier in an attempt to obtain acceptable vision without contact lenses. At the time of presentation, the patient was not satisfied with his vision in the right eye and requested an attempt to improve his vision with a contact lens. The resulting corneal shape after surgery presented some complications, but the patient was able to achieve 20/25-vision and adequate comfort in his right eye with a piggyback contact lens system.
CONCLUSIONS: Insertion of intrastromal corneal rings may be beneficial in patients with early keratoconus or who are contact lens-intolerant. However, patients with more-advanced keratoconus are not likely to achieve adequate vision after the surgery and will require a contact lens. In addition, changes in the corneal anatomy created by the intrastromal rings may make contact lens fitting more challenging. The corneal irregularity may be exacerbated due to drastic variations in corneal elevation over the intrastromal ring and directly adjacent to the ring. This irregularity in elevation leads to difficulty in centering the lens on the eye and problems with bubbles forming under the contact lens over areas of corneal depression. When successfully fitted, contact lenses over intrastromal corneal rings can improve vision significantly.