Clinical performance and fitting characteristics with a multicurve lens for keratoconus.
OBJECTIVE
To evaluate the clinical outcome and fitting characteristics with a multicurve lens for keratoconus in a Korean population.


METHODS
Sixty eyes with keratoconus were fit with a multicurve lens based on topographic index and fluorescein pattern on slitlamp biomicroscopy. Three-point touch was applied in 59 eyes, and apical clearance was adopted in an eye with a persistent epithelial defect. The mean follow-up was 11.4 months. Visual acuity, comfort, glare, daily contact lens-wearing time, and the changes in topographic indices after fitting were evaluated. The relationship between base curve radius (BCR) and topographic indices were analyzed along with the relationship between BCR and peripheral curve radius.


RESULTS
A total of 71.6% of the eyes achieved a visual acuity of 20/30 or better. Flatter BCR was related to better visual acuity. Ninety-four percent of the patients tolerated the fitting, and 85% of them reported complete comfort. The mean daily wearing time was 11.9 hours. Four eyes reported glare. The change of Sim K during follow-up was not statistically significant. Prefitting Sim Kmax and average Sim K were significantly related to the BCR. Mean differences between the BCR and first peripheral curve radius were 1.06 +/- 0.21 mm with a BCR less than 6.00 mm and 0.81 +/- 0.2 mm with a BCR greater than 6.00 mm. These differences were statistically significant.


CONCLUSIONS
Customization with the multicurve lens enabled patients with keratoconus to wear the contact lens comfortably and seemed not to aggravate the progression of keratoconus. Sim Kmax and the relationship between BCR and first peripheral curve radius seem to be useful information to optimize performance of the multicurve lens.
Lee
Jae Lim
JL
Department of Ophthalmology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Kim
Mee Kum
MK
D003261:Contact Lenses; D003315:Cornea / Q000503:physiopathology; D019466:Glare; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000628:therapy*; D017060:Patient Satisfaction; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology