Managing Bilateral Penetrating Keratoplasty-Related Rim Ectasia and Astigmatism

31st August 2023

Introduction This patient is a 51 YO female who had bilateral Penetrating Keratoplasties around 30 years ago in Rotterdam. Her grafts have become ectatic over the years and now exhibit signs of Rim Ectasia. This presents itself as a thinning of the host cornea leading to a tilting of the graft and a significant...

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Type 1 Lattice Corneal Dystrophy Status Post Penetrating Keratoplasty: A Scleral Lens Success Story

31st August 2023

Background Type 1 lattice corneal dystrophy (LCD1) is a rare hereditary bilateral disorder of the cornea. This is a result of an autosomal dominant mutation of the TGFBI (transforming growth factor beta induced) gene which leads to accumulation of amyloid deposits in stroma1 Variable clinical appearance depends on the...

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The Changing Landscape of Keratoconus, the Irregular Cornea & Contact Lens Correction

28th February 2023

Keratoconus, without exception, has always been our number one indication for specialty lenses, particularly scleral lenses, for both pre and post-surgical intervention. Studies from the University of Utrecht, Netherlands, by Godefrooij et al.¹ show that the incidence of keratoconus may be much more common than originally thought. The annual...

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A Fisherman’s Tale – New hyper Dk material eliminates episodes of microcystic edema

31st July 2019

Penetrating keratoplasty in patients with keratoconus may provide good long‐term visual rehabilitation. There is a relatively low rate of graft failure in this cohort of patients. Graft rejection has been reported to be 5.8–41% with most rejections occurring in the first 2 years. [1-5]. Irregular and high astigmatism may be common...

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Scleral Lens Management of Soft Contact Lens Induced Limbal Stem Cell Deficiency

03rd November 2023

Introduction Limbal stem cell deficiency (LSCD) results in dysfunction and/or loss of the stem cells in the basal limbal area. These cells are responsible for maintaining and replenishing the corneal epithelium. This change in corneal tissue composition results in conjunctival epithelial ingrowth, persistent epithelial defects, chronic inflammation, and neovascularization.1,5 There...

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