Use of intralimbal rigid gas-permeable lenses for pellucid marginal degeneration, keratoconus, and after penetrating keratoplasty.
OBJECTIVE
To discuss the results of fitting Dyna Intra-Limbal lenses (Lens Dynamics, Inc., Golden, CO) (DIL) for pellucid marginal degeneration (PMD), keratoconus, and after penetrating keratoplasty (PK).


METHODS
The charts of patients fitted with DILs between January 2003 and December 2004 were retrospectively reviewed. Ocular diagnosis, indication for DIL, flat and steep curvatures by corneal topography, and age at the time of initial fitting were noted. The DIL data included initial base curve, power, and the number of changes made in parameters during the follow-up. The outcome data included visual acuity and the duration of follow-up and lens wear. Complications and complaints were also noted.


RESULTS
Twenty-seven eyes of 22 patients were reviewed. Fourteen eyes had PMD; seven had keratoconus; and six eyes had undergone PK. The mean age of patients was 52.7 +/- 13.1 years. The mean follow-up was 8.9 +/- 7.4 months. Nine (33.3%) eyes achieved 20/20 visual acuity; 13 (48.1%) eyes achieved 20/25 to 20/40; and five (18.5%) eyes achieved 20/50 to 20/70. Fifteen (55.6%) eyes achieved visual improvement (two lines or more). The mean number of refits was 1.1 +/- 0.9. No infection or neovascularization was noted; a corneal abrasion occurred in one eye. Good wearing time was achieved in 18 (66.7%) eyes of 13 patients, who were still wearing DILs at the last follow-up.


CONCLUSIONS
DILs may be a good alternative in selected patients with flat central and superior corneas and inferior peripheral steepening.
Ozbek
Zeynep
Z
Cornea Service, Wills Eye Hospital, Philadelphia, PA 19107, USA.
Cohen
Elisabeth J
EJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003262:Contact Lenses, Extended-Wear; D003317:Corneal Dystrophies, Hereditary / Q000473:pathology / Q000628:therapy*; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000473:pathology / Q000628:therapy*; D015948:Keratoplasty, Penetrating; D016850:Limbus Corneae; D008297:Male; D008875:Middle Aged; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D014792:Visual Acuity