Feasibility of custom-made hydrogel contact lenses in keratoconus with previous implantation of intracorneal ring segments

• We analyze the feasibility of a custom-made hydrogel silicone contact lens (CL) in keratoconus with intracorneal ring segments (ICRS).
• We compare outcomes taking in consideration the geometry of the fitted lens.
• Statistically significant improvement was observed between LogMAR CDVA and CLVA with adequate wearing time and low level of complications.
• SMC designs were recorded and associated with lower levels of CDVA and larger amounts of CPV-diff than those eyes fitted with FP.

PurposeTo analyze the feasibility of a custom-made hydrogel silicone contact lens (CL) in keratoconus with intracorneal ring segments (ICRS) and to compare outcomes taking in consideration the geometry of the fitted lens—full periphery (FP) vs. sector management control (SMC).MethodA retrospective review of cases with previous KeraRings ICRS implantation and subsequently fitted with Kerasoft-IC CL was performed. The main outcome measurements were corrected spectacle distance visual acuity (CDVA), differences between flat and steep simulated keratometries (K-diff) and between steep and flat P values (CPV-diff), CL visual acuity (CLVA), wearing time (WT) and complications associated with wear.ResultsThirty eyes of 22 patients and a follow-up time of 10.3 ± 2.3 months were reviewed. Statistically significant improvement was observed between LogMAR CDVA and CLVA (0.25 ± 0.19 vs. 0.04 ± 0.05; P < 0.0001). WT was 11.2 h ± 1.2. Two eyes with mild corneal staining and another two with mild injection were noted. Twenty SMC designs were recorded and associated with lower levels of CDVA (0.36 ± 0.22 vs. 0.18 ± 0.10; P = 0.006), CLVA (0.06 ± 0.05 vs. 0.01 ± 0.03; P = 0.03), and larger amounts of CPV-diff (2.31 ± 1.86 vs. 1.03 ± 1.11; P = 0.02) than those eyes fitted with FP designs. No statistical differences were found in the amount of K-diff and WT between both sub-groups.ConclusionsFitting custom-made hydrogel silicone CL in keratoconus with ICRS is a feasible treatment with low rate of complications and adequate visual acuity and WT.

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