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Limbal RGP lenses on Keratoconus with corneal cross-linking treatment – case 44
Fantasee Incorporated 3F-2, No.202, Sec. 3, Datong Rd., Xizhi Dist., New Taipei City 22103, Taiwan (R.O.C.)
A 28 year-old female patient with history of recurrent keratitis from wearing disposable contact lenses on a daily basis has come to seek for medical attention. The patient was then diagnosed with keratoconus with corneal topography. The steepest curve is 49D on the right eye while 48.3D on the left respectively (Figure 1 and 2). A brief profile of the patient is provided below:   Right (OD) Left (OS) Curvature (steep K) 49D 48.3D Myopia -7.00D -7.50D Astigmatism -1.00D -1.50D Fortunately, the bulging area of the right eye (Figure 3 and 4) is located 2 mm away from the center of the cornea while the bulging area of the left eye is located 1.5 mm outside the center of the cornea which makes more astigmatism on the left eye because the closer the cone is to the center of the cornea, the higher the astigmatism a patient will experience.With fitting of limbal RGP lenses (Figure 5 and 6), the patient’s best corrected visual acuity is 1.0 on the right eye and 0.9 on the left eye respectively. According to the patient, the comfort scale of wearing the limbal RGP lenses is about 90 (out of 100), similar to wearing daily disposable contact lenses.Figure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6. http://www.fantasee.com.tw/hot_260311.html Limbal RGP lenses on Keratoconus – case 1 2023-04-24 2024-04-24
Fantasee Incorporated 3F-2, No.202, Sec. 3, Datong Rd., Xizhi Dist., New Taipei City 22103, Taiwan (R.O.C.) http://www.fantasee.com.tw/hot_260311.html
Fantasee Incorporated 3F-2, No.202, Sec. 3, Datong Rd., Xizhi Dist., New Taipei City 22103, Taiwan (R.O.C.) http://www.fantasee.com.tw/hot_260311.html
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Home ﹥ NEWS > KERATOCONUS CAS > Limbal RGP lenses on Keratoconus with corneal cross-linking treatment – case 4

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A 37 year-old male patient diagnosed with keratoconus in the early 20s was initially fitted with traditional RGP lens which gave him clear vision. Seven years later, he began to experience blurry vision and slight pain on the right eye upon wearing RGP lens. He then switched to scleral RGP contact lens, but conditions remained the same. Therefore, the patient came to seek for medical advice in which he was diagnosed with keratitis on both eyes and corneal leukoma on the right eye (Figure 1). With a subjective refraction of -6.50 -0.25 x 130 OS, the best-corrected visual acuity (BCVA) was 1.0 on the left eye. However, the refraction and keratometry of right eye cannot be detected by the autorefracto keratometer as the curvature of the cornea being too steep. The optical coherence tomography (OCT) indicated the cornea thickness of both eyes were relatively thin with 468 microns on the right eye and 510 microns on the left eye respectively (Figure 3 and 4). Based on the corneal topography (Figure 5 and 6), the corneal curvature of the right eye was a lot steeper than the left eye. The patient was later treated with corneal cross-linking (CXL) on the right eye only since it has worsened significantly. Although the corneal hazziness have increased after CXL, the pupil was not completely blocked. The patient was then fitted with limbal RGP lens two months later. With limbal RGP lenses, the patient could have a vision of 1.0 on the right eye and 1.2 on the left eye respectively (Figure 7 and 8) and no keratitis having been noted. Vision remained stable after two years, but conditions of corneal leukoma still exists (Figure 9 to 11).

Figure 1. Corneal leukoma on the right eye
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Figure 2. Left eye cornea
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Figure 3. OCT of right eye cornea
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Figure 4. OCT of left eye cornea
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Figure 5. Corneal topography of right eye indicated a severe keratoconus with a very steep curvature (black color) located at the middle part.
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Figure 6. Corneal topography of left eye indicated a mild keratoconus at the lower part.
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Figure 7. Limbal RGP lens fitting on right eye.
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Figure 8. Limbal RGP lens fitting on left eye.
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Figure 9. Corneal leukoma on the right eye – two years later (front view)
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Figure 10. Corneal leukoma on the right eye – two years later (side view)
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Figure 11. Corneal leukoma on the right eye – two years later (OCT)
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