Refitting a patient with pellucid marginal degeneration from a corneal rigid gas permeable lens to scleral lens

Authors

  • Eilin Lundanes University of South-Eastern Norway
  • Jörgen Gustafsson

DOI:

https://doi.org/10.5384/sjovs.vol13i1p19-23

Abstract

This case report describes a 66 years old male patient with pellucid marginal degeneration (PMD). The patient had fallen out of a regular follow-up scheme and presented with a poorly fitting corneal rigid lens that he had worn for almost five years. Correction had failed to improve vision in the left eye, so the patient wears a contact lens in his right eye only. Scleral lenses vault over the cornea, the tear layer between the lens and the cornea masks corneal irregularities and are a good correction option for corneal ectasias. This patient was fitted with an Onefit scleral lens that provided good visual acuity and comfort. Lens handling was no obstacle to this patient. A heart surgery postponed the first follow-up examination. Follow-up examination 8 months after the refit resulted in no changes of lens parameters as the fitting was still acceptable and the patient was happy. Attention to the inferior limbal clearance will be the focus at the next follow-up in 6 months’ time. 

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References

Asena, L., & Alt?nörs, D. D. (2016). Clinical outcomes of scleral Misa lenses for visual rehabilitation in patients with pellucid marginal degeneration. Contact Lens and Anterior Eye, 39(6), 420-424. https://doi.org/https://doi.org/10.1016/j.clae.2016.06.010

Belin, M. W., Asota, I. M., Ambrosio, R., & Khachikian, S. S. (2011). What's in a Name: Keratoconus, Pellucid Marginal Degeneration, and Related Thinning Disorders. American Journal of Ophthalmology, 152(2), 157-162.e151. https://doi.org/10.1016/j.ajo.2011.03.028

Biswas, S., Brahma, A., Tromans, C., & Ridgway, A. (2000). Management of pellucid marginal corneal degeneration. Eye, 14, 629-634.

BlanchardContactLenses. (2018). Onefit scleral lens platform fitting guide. http://blanchardlab.com/wp-content/uploads/2018/09/Onefit-Fittingguide-08-13-18-Web.pdf

Bray, C., Britton, S., Yeung, D., Haines, L., & Sorbara, L. (2017). Change in over?refraction after scleral lens settling on average corneas. Ophthalmic and Physiological Optics, 37(4), 467-472. https://doi.org/10.1111/opo.12380

Efron, N. (2018). Contact lens practice (Third edition. ed.). Elsevier.

Fadel, D. (2019). Scleral Lens Issues and Complications Related to a Non-optimal Fitting Relationship Between the Lens and Ocular Surface. Eye Contact Lens, 45(3), 152-163. https://doi.org/10.1097/icl.0000000000000523

Fadel, D., & Kramer, E. (2019). Potential contraindications to scleral lens wear. Contact Lens and Anterior Eye, 42(1), 92-103. https://doi.org/10.1016/j.clae.2018.10.024

Jinabhai, A., Radhakrishnan, H., & O'Donnell, C. (2011). Pellucid corneal marginal degeneration: A review. Cont Lens Anterior Eye, 34(2), 56-63. https://doi.org/10.1016/j.clae.2010.11.007

Koc, M., Tekin, K., Inanc, M., Kosekahya, P., & Yilmazbas, P. (2018). Crab claw pattern on corneal topography: pellucid marginal degeneration or inferior keratoconus? Eye (Lond), 32(1), 11-18. https://doi.org/10.1038/eye.2017.198

Martinez-Abad, A., & Pinero, D. P. (2019). Pellucid marginal degeneration: Detection, discrimination from other corneal ectatic disorders and progression. Contact Lens and Anterior Eye, 42(4), 341-349. https://doi.org/10.1016/j.clae.2018.11.010

Michaud, L., Lipson, M., Kramer, E., & Walker, M. (2019). The official guide to scleral lens terminology. Contact Lens and Anterior Eye. https://doi.org/10.1016/j.clae.2019.09.006

Otchere, H., Jones, L. W., & Sorbara, L. (2017). Effect of Time on Scleral Lens Settling and Change in Corneal Clearance. Optometry and Vision Science, 94(9), 908-913. https://doi.org/10.1097/opx.0000000000001111

Ozek, D., Kemer, O. E., & Altiaylik, P. (2018). Visual performance of scleral lenses and their impact on quality of life in patients with irregular corneas. Arquivos Brasilieiros De Oftalmologia, 81(6), 475-480. https://doi.org/10.5935/0004-2749.20180089

Pullum, K. W., & Buckley, R. J. (1997). A study of 530 patients referred for rigid gas permeable scleral contact lens assessment. Cornea, 16(6), 612-622.

Rathi, V. M., Dumpati, S., Mandathara, P. S., Taneja, M. M., & Sangwan, V. S. (2016). Scleral contact lenses in the management of pellucid marginal degeneration. Contact Lens and Anterior Eye, 39(3), 217-220. https://doi.org/10.1016/j.clae.2015.11.005

Walker, M. K., Bergmanson, J. P., Miller, W. L., Marsack, J. D., & Johnson, L. A. (2016). Complications and fitting challenges associated with scleral contact lenses: A review. Contact Lens and Anterior Eye, 39(2), 88-96. https://doi.org/10.1016/j.clae.2015.08.003

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Published

2020-07-31

How to Cite

Lundanes, E., & Gustafsson, J. (2020). Refitting a patient with pellucid marginal degeneration from a corneal rigid gas permeable lens to scleral lens. Scandinavian Journal of Optometry and Visual Science, 13(1), 19–23. https://doi.org/10.5384/sjovs.vol13i1p19-23

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Case Report