title: High-Dk piggyback contact lenses over Intacs for keratoconus: a case report.
abstract: OBJECTIVE
  The authors describe a case of a keratoconic patient with Intacs fitted with a high-Dk piggyback contact lens system.
  
  
  METHODS
  A 41-year-old man presented to the clinic 1 week after Intacs surgery for keratoconus with complaints of poor visual acuity (VA) and monocular polyopia OU. The patient was corrected to 20/30 in both eyes with rigid gas permeable contact lenses but could not tolerate the lenses for more than 8 hours OD and 2 hours OS. The patient was then successfully fit with a high-Dk piggyback contact lens system.
  
  
  RESULTS
  The patient was able to wear the piggyback contact lenses comfortably 12 to 18 hours per day and was corrected to 20/25 OD, 20/30 OS, and 20/20 OU.
  
  
  CONCLUSIONS
  Patients with Intacs for keratoconus may require a combination of soft and rigid contact lenses for the best possible VA. Contact lens fitting with a high-Dk piggyback contact lens system can provide optimal comfort, corneal health, and VA for patients with Intacs for keratoconus.
authors.affiliation: Katterbach Health Clinic, US Army, Katterbach, Germany. kyle.a.smith2@us.army.mil
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Smith
authors.forename: James D
authors.initials: JD
authors.lastname: Carrell
mesh_terms: D000328:Adult; D003263:Contact Lenses, Hydrophilic; D003319:Corneal Stroma / Q000601:surgery; D019781:Corneal Topography; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007640:Keratoconus / Q000601:surgery / Q000628:therapy*; D008297:Male; D019736:Prostheses and Implants; D017755:Prosthesis Fitting; D012828:Silicones; D014792:Visual Acuity
chemical_list: D012828:Silicones; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate