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Contact Lenses as the best Conservative Treatment of Newly Diagnosed Keratoconus – Epidemiological Retrospective Study
Danijela Mrazovac
orcid.org/0000-0003-2221-4635
; Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
Marija Barišić Kutija
; Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
Sania Vidas
; Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
Tomislav Kuzman
; Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
Igor Petriček
; Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
Sonja Jandroković
; Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
Miro Kalauz
; Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
Branimir Cerovski
; Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
Sažetak
Keratoconus is a progressive, non-infl ammatory corneal ectasia characterized by thinning and weakening of the corneal
stroma which results in its’ protrusion. The onset is during puberty and progresses until the fourth decade of life. In
earlier stages, good visual acuity can be provided with spectacles. With progression, contact lenses are considered to be a
better therapy. Aim of this study was to determine if there is statistically signifi cant difference between best corrected visual
acuity (BCVA) obtained by spectacles and contact lenses in newly diagnosed keratoconus patients, as well as to determine
which type of contact lenses provide better BCVA in keratoconus patients. We conducted a 5-year retrospective
study of all 2891 patients attending our Contact Lens Department for the fi rst time, searching for patients newly diagnosed
with keratoconus. Data were obtained on gender, age, education level, treated eyes, corneal changes, keratoconus severity,
BCVA with spectacles, contact lenses and best fi tted contact lens type. All patients underwent standard ophthalmic exam,
refractometry and keratometry have been done, followed by a spectacles correction and lens fi tting. Wilcoxon signed rank
test was used for statistical analysis. Results showed that of all 2891 patients examined for the fi rst time, 137 patients
(4.74%) have been newly diagnosed with keratoconus, there was male bias (72.26%), mean age 27.7±9.9 years. Most patients
had high school education (51.11%), 3.70% had present corneal changes, 50.37% had mild keratoconus. Majority had
keratoconus on both eyes (36.3%) or keratoconus of right eye (26.67%). There was a statistically signifi cant difference
(p<0.001) between the BCVA obtained with contact lenses (0.82±0.21 Snellen chart) rather than spectacles (0.37±0.27
Snellen chart). The best corrected visual acuity was achieved with rigid gas permeable (RGP) lenses in majority of keratoconus
eyes (51.85%), with semi-gas permeable (SGP) lenses in 43.39%, in 4.23% with polymethyl methacrylate (PMMA)
lenses and with hard-soft gas permeable (GP) contact lenses in 0.53% of keratoconus eyes. We have showed that there is
a statistically signifi cant difference in BCVA achieved better with contact lenses than with spectacles. RGP lenses are most
frequently used in conservative treatment of keratoconus, but SGP lenses were also shown to be a good option that gives
equally satisfying fi nal visual acuity with subjective comfortable feeling of contact lens wear.
Ključne riječi
keratoconus; retrospective study; spectacles; contact lenses; visual acuity; cornea
Hrčak ID:
147395
URI
Datum izdavanja:
26.12.2014.
Posjeta: 1.294 *