1. CONTACT LENSES FOR EXTREME ECTASIA- A COMPARATIVE ANALYSIS
JATIN ASHAR
MUMBAI EYE CARE CORNEA AND LAISK CENTRE

2. NO FINANCIAL DISCLOSURE

3. Contact Lens in Extreme Ectasia
Old wine in a new bottle!
Rose K - XL
Semi Scleral and Scleral CL
Hybrid CL

4. Topography Based Traditional CL Fitting Guide

5. Principle of Large Diameter Lenses

6. Vaulting Is The Key

9. Fitting CL in Extreme Ectasia

10. Case 1
Fitted with Rose K XL
Visual acuity with CL - 6/6 p

11. Case 1

12. Case 2
Fitted with Europa Scleral CL
Visual acuity - 6/9

14. Case 3
Fitted with an hybrid contact lens
Visual acuity- 6/9

16. Comparative Analysis- Which Lens Stands Out!
Comparison of Rose K XL (14.2mm) / Hybrid CL (Clearkone, Synergeyes, USA) (14.5mm) / Semi Scleral 15.2 mm (Jupiter, USA), Scleral 18.2mm (Jupiter, USA) / Europa 16mm (USA)
Parameters studied-
Visual outcome
Comfort
Chair time

17. 24 cases of ectasia with Mean K > 60 D
10 – Keratoconus
6 – Pellucid Marginal Degeneration
4 – Post LASIK
4 - Post RK
All cases were fitted with hybrid/ Rose K XL and Semi-scleral/ Scleral lenses sequentially

18. Results Visual acuity improved in all from mean less than 0.1 to 0.9
For keratoconus all lenses fit equally well
For PMCD and Post LASIK/ RK – peripheral design modification is needed for Rose K XL lenses- increasing chair time and increased number of trials
Reverse geometry design of Europa and RG- Scleral contact lenses required minimal design modification and give excellent comfort
E CL & H CL were most comfortable for patients
Subjective visual improvement - maximum with H CL

19. Conclusion
Battle against the bulge doesn't always need a surgical knife
All it needs is to mask it with an appropriate contact lens