Feasibility of contact lens fitting on keratoconus patients with INTACS inserts

To demonstrate the feasibility of contact lens fitting in keratoconus patients with INTACS inserts.

A chart review was conducted of all patients with bilateral keratoconus who were treated with INTACS inserts on one eye and who were subsequently referred for contact lens fitting in a university based contact lens practice between April 2000 and April 2002. The study was a retrospective, non-comparative case series. The uncorrected and best spectacle corrected visual acuity (BSCVA) after INTACS implantation surgery, postoperative best contact lens-corrected visual acuity (BCLVA), number of diagnostic contact lenses used, number of contact lenses ordered within a 4-month follow-up period, contact lens complications encountered, final base curves, final lens powers, and final wearing times were determined.

Three keratoconic patients meeting the selection criteria were found through the chart review. Prior to surgery, all patients had uncorrected visual acuity (UCVA) of 2.0 logMAR (counting fingers). This improved to a mean of 0.81+/-0.25 logMAR (20/125-1) after surgery. Mean BSCVA also improved from 0.51+/-0.30 logMAR (20/60-2) to 0.30+/-0.16 logMAR (20/40). The mean postoperative best contact lens-corrected visual acuity was 0.02+/-0.10 logMAR (20/20-1). The number of diagnostic lenses ranged from 1 to 7. The numbers of contact lenses ordered during the 4-month follow up period ranged from 1 to 3. Two eyes were fitted with larger than usual lens designs made of rigid gas-permeable material and one eye was fitted with a toric soft lens. The final lens power ranged from +1.25 to -21.0D with a mean spherical equivalent of -7.46+/-11.89 D. Final wearing times ranged from 2.5 to 12.0h.

Fitting contact lenses on keratoconus patients who have INTACS inserts is feasible and has a role in augmenting their vision.