Oftalʹmologiâ (Oct 2024)
Experience of Using Scleral Contact Lenses in Keratoconus in Combination with Dry Eye Syndrome
Abstract
Relevance. Currently, a number of numerous publications have proven the comorbidity of keratoconus (CC) with dry eye syndrome (dry eye). The modern method of optical rehabilitation of CC includes scleral rigid gas-permeable lenses (SGCL). In addition to compensating for refractive disorders, this type of lens has increasingly been used in the treatment of SSG, in order to protect the cornea and tear film. Purpose: to assess the change in the state of the precorneal tear film in CC in combination with SSG against the background of wearing SGCL.Patients and methods. 31 patients (62 eyes) with bilateral stabilized non-operated CC of various stages were examined, for whom individual SGCLS were selected. A comprehensive assessment of the condition of the tear film included the following methods: biomicroscopy of the anterior segment of the eye using vital dyes, functional tests (Norn, Schirmer, Jones test), OCT-meniscometry, as well as filling out the OSDI questionnaire by patients and an oral survey on subjective sensations against the background of wearing this type of lenses. The studies were carried out before, after 1 and 3 months on the background of wearing lenses.Results. Prior to the selection of SGCL, an increase in the areas of staining of the ocular surface with vital dyes, a decrease in the results of functional tests and OCT meniscometry, as well as high scores according to the OSDI questionnaire were recorded. After 1 month of wearing lenses, the indicators of all studies showed a tendency to improve the condition of the tear film, and after 3 months there were significant changes relative to the initial data. An oral survey showed full adaptation to the SGCL and wearing comfort in 87 % of cases.Conclusion. A comprehensive assessment of the condition of the tear film in CC in combination with signs of SSG before and against the background of wearing individual SGCL indicates an improvement in the condition of the ocular surface and stabilization of the precorneal tear film, which proves the effectiveness of this type of correction for both optical and protective purposes.
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