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A 34 year-old male patient was diagnosed with keratoconus since childhood and had dealt with blurry vision and irregular astigmatism for quite some time. At the age of 20, he was treated with corneal transplant (Figure 1 and 2) at a medical center located in Taiwan. However, the patient still experienced blurry vision due to irregular astigmatism afterwards. Then, he came to our clinic for fitting of RGP contact lenses.
With a subjective refraction of -2.25D/ -1.00D x 30 (right eye) and -2.00D/ -6.00D x 35 (left eye), the best-corrected visual acuity were 0.8 on the right and 0.5 on the left side respectively. The corneal topography showed irregular astigmatism on the both eyes (Figure 3 and 4). Obviously, the cornea curvature of the left eye is more distorted than the right eye causing severe irregular astigmatism.
To achieve the appropriate fitting, we designed 9 curves on the back surface of the RGP lenses. With using this limbal RGP lenses, the patient can have a vision of 20/20 on the both eyes respectively (Figure 5 and 6).
Figure 1. Corneal transplant on right eye.
Figure 2. Corneal transplant on left eye.
Figure 3. Corneal topography of right eye.
Figure 4. Corneal topography of left eye.
Figure 5. Limbal RGP lens fitting on right eye.
Figure 6. Limbal RGP lens fitting on left eye.