contact lens focus

Meeting the Challenge

Lens provides comfort, clarity and ease of fit.

Corrie Pelc, Contributing Editor

As any optometrist that treats patients with keratoconus or irregular corneas will tell you, fitting these particular patients with contact lenses can be challenging.

Enter the KeraSoft IC lens from Bausch + Lomb, which Winter Park, Fla., optometrist Dr. Brad Giedd calls, “a needed addition to a specialty market for managing patients with keratoconus, corneal disorders, things that make contact lens fitting difficult. (It's for) specialty types of contact lens patients who sometimes have no other alternative.”

Overview

According to Dr. Greg De-Naeyer, who practices in Columbus, Ohio, the KeraSoft IC lens is a lathe-cut, custom design lens that is manufactured with Definitive SiHy material in order to maximize oxygen permeability. He says the lens offers the same comfort you would expect from a soft contact lens due to the use of silicone hydrogel material. “The niche patient for this type of lens or design is the patient who had been previously uncomfortable in gas permeable lenses,” he explains.

Dr. DeNaeyer gives the example of a patient with moderate keratoconus who was fit with a scleral lens but was not satisfied with having to wear a rigid contact lens. “We refit him into the KeraSoft IC lens and it got him acceptable vision,” Dr. DeNaeyer explains. “He was very satisfied with the comfort the lens provided him versus the gas permeable scleral lens.”

Rochester, N.Y., practitioner Dr. Robert Ryan believes tolerance and wearability are two major keys to the KeraSoft IC lens, as he has found patients are able to wear this lens for longer durations. “This product allows patients to go from perhaps eight hours of wear to nearly all day without discomfort, so if they're looking to have a life in the evening this can certainly be a product that can help them with that,” he adds.

Dr. Giedd says the KeraSoft IC lens has a significant improvement in what patients are able to achieve from a visual acuity standpoint, compared to other soft lenses he has used on keratoconus patients. “Historically any type of soft or soft toric lens on a keratoconus patient is typically a compromise, whereas I'm finding that to be far less of an issue with this,” he explains.

Dr. Giedd cites one of his patients with a mild case of keratoconus who wore a soft contact lens. He decided to fit her with the Kera-Soft IC lens. “(She) experienced several lines of improvement in acuity with the lens, so that was a help for her because that had been a complaint she had had over the long haul,” he says.

Additionally, Dr. DeNaeyer says the KeraSoft IC lens has a balanced center thickness design that is able to effectively mask mild to moderate amounts of corneal irregularity. “So for patients who have either mild keratoconus or mild irregularity, they may be expected to achieve 20/20 acuity,“ he says. “And for patients that have more moderate irregularity, their visual acuity range would be somewhere between 20/20 and 20/30.”

Fitting

Dr. Ryan says the fit of the KeraSoft IC lens represents a shift from what optometrists have been accustomed to when treating patients with keratoconus and corneal irregularities. Overall, he says the fit of these lenses tends to be a little more forgiving. “We don't need to be quite as exact with our parameters, and we don't have as many parameters to select from as we do with RGP-type lenses that we're accustomed to fitting these folks with,” he explains.

Additionally, Dr. Ryan says he has found the KeraSoft IC lens tends to center much better than other lenses he has used for these types of patients in the past, and the lens tends to orient pretty consistently, which he says is imperative to its success. He also mentions the KeraSoft IC lens tends to move more on the eye than other materials.

“So the movement tends to be a little more generous,” he reiterates. “Centration tends to be a very positive attribute of this lens, as does the orientation.”

Chair time/R.O.I.

Because the KeraSoft IC lens is a custom lens, it requires more chair time than a standard soft toric contact lens. However, Dr. DeNaeyer feels that the patient will be more than happy with the results.

“It may require some more chair time, but the benefit outweighs that cost because the visual acuity is so much better.” Dr. DeNaeyer says.

Versus more traditional gas permeable lenses, the KeraSoft IC lens is a corneal replacement lens that the patient will have to have updated annually. Due to the results the patient will see, this should lead to a great deal of patient loyalty and retention.

“It's a quarterly replacement lens, so they're going to have to renew that every year,” Dr. DeNaeyer says. “And because it's a specialty custom lens, they are more likely to purchase them through your office.”

Overall, all three practitioners have found the KeraSoft IC lens to be a solid option when treating hard-to-fit keratoconus and irregular cornea patients. OM