Advances in Non-surgical Treatment Methods in Vision Rehabilitation of Keratoconus Patients

Ersin Muhafiz

doi:10.5772/intechopen.94250

Abstract

Visual acuity decreases due to progressive irregular astigmatism in keratoconus (KC). Although glasses can be useful in the initial stages of vision rehabilitation, contact lenses (CL) are needed in many patients due to irregular astigmatism. Although rigid gas permeable (RGP) CLs provided the patient with a better visual acuity than glasses, their effects on corneal tissues and caused comfort problems. Although soft CL produced for KC have solved some of these problems, they could not increase visual acuity as much as RGPs in advanced stage KC. For this reason, new searches for vision rehabilitation and comfort in KC have continued. In this context, piggyback contact lenses (PBCL) have been used in vision rehabilitation. Hybrid CLs have gained popularity due to the fact that PBCLs cause corneal neovascularization and giant papillary conjunctivitis. Scleral CLs have been developed for limited benefit in some patients with advanced KC. Scleral CLs provided good vision rehabilitation. The biggest problem of scleral CLs is the application and removal difficulty. All these CL modalities try to improve the quality of life and delay surgical procedures by increasing the level of vision in patients with KC.

Highlights

With the latest advances in contact lenses (CL) features and design, many CL options have been developed for patients with corneal irregularities, such as large diameter rigid gas permeable (RGP) lenses, scleral lenses, hybrid lenses and KC specific soft lenses
It was determined that the virtual sodium fluorescein staining pattern created based on the data from the CL simulator in the corneal topography and the actual staining pattern observed in the slit lamp were found to be highly matched. These findings show the importance of video keratoscopic virtual applications in CL management in KC patients and they have the potential to reduce the time we spend for CL [23, 71]
Despite current surgical advances in KC treatment, CLs continue to be important for visual rehabilitation in KC

Summary

Introduction

Keratoconus (KC) is the most common ectatic disease of the cornea. It is characterized by progressive thinning and protrusion of the cornea [1, 2]. KC in children may have negative effects on social and educational development In this respect, it is necessary to improve the vision in children at an acceptable level [4]. It is necessary to improve the vision in children at an acceptable level [4] This disease, which mostly starts in young adults, can be seen in children. Considering that CLs cause ocular surface changes even in non-KC individuals, the main purpose of CL application in KC should be to increase visual acuity without compromising the health of the cornea and ocular surface [9]. With the latest advances in CL features and design, many CL options have been developed for patients with corneal irregularities, such as large diameter RGP lenses, scleral lenses, hybrid lenses and KC specific soft lenses. 2. Advances in non-surgical treatment methods in vision rehabilitation of keratoconus patients

Spectacles

Soft contact lenses

Rigid gas permeable contact lenses

Piggyback contact lenses

Hybrid contact lenses

Scleral contact lenses

The role of new imaging technologies in contact lens fitting in keratoconus

Findings

Conclusions