title: Unique hard scleral lens post-LASIK ectasia fitting.
abstract: OBJECTIVE
  This case report describes an experience with prosthetic replacement of ocular surface ecosystem (PROSE) device in an Indian patient with post-LASIK corneal ectasia.
  
  
  METHODS
  Keratoconus and corneal ectasia (post-LASIK) are characterized by progressive thinning and steepening of the cornea. Common symptoms experienced by patients in such conditions range from mild to severe vision impairments to an array of visual symptoms such as glare and ghosting. Scleral lenses are considered a vision-saving device when all other modalities fail. The patient in this case report had larger palpebral aperture, steeper cornea, and increased toricity of the sclera. Although a larger-diameter device is preferable in steeper corneas, a device with a smaller diameter and a flatter haptic was prescribed because of scleral toricity. There is a need to study scleral profile as well because scleral toricity can produce symptoms in patients even after 6 hours of device wear. After a few days of adaptation, the vault of the PROSE device can change because of haptic alignment on the sclera.
  
  
  CONCLUSIONS
  This case report gives an overview of how the scleral profile can have an effect on the corneal/contact lens relationship when using a PROSE device.
authors: *PhD †MPhil(Optom) Contact Lens Department, Medical Research Foundation, Sankara Nethralaya, Chennai, India (all authors).
authors: Rajeswari
authors: R
authors: Mahadevan
authors: Divya
authors: D
authors: Jagadeesh
authors: Rajni
authors: R
authors: Rajan
authors: Amudha Oli
authors: AO
authors: Arumugam
mesh_terms: D000328:Adult; D001705:Bioprosthesis; D003261:Contact Lenses; D019781:Corneal Topography; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D020731:Keratomileusis, Laser In Situ; D008297:Male; D011183:Postoperative Complications; D017755:Prosthesis Fitting; D012029:Refraction, Ocular; D012590:Sclera; D014786:Vision Disorders / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology