title: Feasibility of custom-made hydrogel contact lenses in keratoconus with previous implantation of intracorneal ring segments.
abstract: OBJECTIVE
  To analyze the feasibility of a custom-made hydrogel silicone contact lens (CL) in keratoconus with intracorneal ring segments (ICRS) and to compare outcomes taking in consideration the geometry of the fitted lens-full periphery (FP) vs. sector management control (SMC).
  
  
  METHODS
  A retrospective review of cases with previous KeraRings ICRS implantation and subsequently fitted with Kerasoft-IC CL was performed. The main outcome measurements were corrected spectacle distance visual acuity (CDVA), differences between flat and steep simulated keratometries (K-diff) and between steep and flat P values (CPV-diff), CL visual acuity (CLVA), wearing time (WT) and complications associated with wear.
  
  
  RESULTS
  Thirty eyes of 22 patients and a follow-up time of 10.3±2.3 months were reviewed. Statistically significant improvement was observed between LogMAR CDVA and CLVA (0.25±0.19 vs. 0.04±0.05; P<0.0001). WT was 11.2h±1.2. Two eyes with mild corneal staining and another two with mild injection were noted. Twenty SMC designs were recorded and associated with lower levels of CDVA (0.36±0.22 vs. 0.18±0.10; P=0.006), CLVA (0.06±0.05 vs. 0.01±0.03; P=0.03), and larger amounts of CPV-diff (2.31±1.86 vs. 1.03±1.11; P=0.02) than those eyes fitted with FP designs. No statistical differences were found in the amount of K-diff and WT between both sub-groups.
  
  
  CONCLUSIONS
  Fitting custom-made hydrogel silicone CL in keratoconus with ICRS is a feasible treatment with low rate of complications and adequate visual acuity and WT.
authors.affiliation: Centro Fernández-Velázquez, Madrid, Spain. Electronic address: info@fernandez-velazquez.com.
authors.forename: Fernando José
authors.initials: FJ
authors.lastname: Fernández-Velázquez
authors.affiliation: Centro Fernández-Velázquez, Madrid, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Fernández-Fidalgo
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003263:Contact Lenses, Hydrophilic; D003315:Cornea; D019781:Corneal Topography; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020100:Hydrogels; D007640:Keratoconus / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D020100:Hydrogels
keywords: Ferrara; Intracorneal rings; Irregular astigmatism; KeraRings; Keratoconus; Silicone hydrogel contact lenses