RA Case Study.pdf - UltraVision Group

www.kerasoft.co.uk
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History
RA Clinical Notes
RA is a 30 year old female who developed ectasia following LASIK surgery 7 years previously. Before the
surgery, she was a bilateral -7.00 myope with a spherical prescription with no sign of sub-clinical
keratoconus. One year after the LASIK surgery, she began to develop astigmatism and her vision became
steadily worse until it deteriorated rapidly a year before this consultation. She returned to the laser treatment
company where she was given a diagnosis of post LASIK ectasia and was fitted with RGP contact lenses.
She could not tolerate these at all and was referred for Corneal Cross Linking (CXL), undergoing the
procedure for the right eye in March 2008. After the CXL her Ophthalmologist referred her for contact lens
assessment whilst still monitoring the thickness of the left cornea. She was struggling at work (child care) as
her vision was variable and ghosting was caused by her irregular corneas. She was also finding it difficult to
drive at night due to ghosting and multiple images of lights.
Initial Findings
Vision:
RE: Count Fingers LE: 3/24
Spectacle Rx:
RE: -8.00/-4.50 x 87 VA 6/12
LE: -2.25/-2.50 x 95 VA 6/9 with severe ghosting
Keratometry:
RE: 7.70 x 100/7.02 x 10 LE: 7.09 x 97/6.56 x 7
Topography:
RE
LE
Rationale for KeraSoft ® Fitting
After being diagnosed with post LASIK ectasia, RA had tried rigid lenses and felt they were too uncomfortable
to wear. Also they had the tendency to fall out when she moved her eyes rapidly. Additionally, the surgeon
indicated he would prefer her to be fitted with a soft lens option following corneal cross linking surgery. She
therefore wanted to try KeraSoft ® contact lenses.
UltraVision International Ltd, Commerce Way, Leighton Buzzard, Beds, LU7 4RW
UK Freephone 0800 585115 or +44 (0)1525 381112
email: info@ultravision.co.uk web: www.ultravisiongroup.com

®
RA Clinical Notes Cont’d
Slit Lamp
Right cornea slightly hazy centrally. Patchy punctate staining inferiorly RE and LE.
Initial KeraSoft ® 3 Fitting
RE: 8.60/14.50/-6.00/-3.50 x 87 VA 6/7 LE: 8.60/14.50/-2.00/-2.50 x 110 VA 6/7
RA was able to wear the KeraSoft ® 3 lenses all day with excellent comfort.
3 Month Follow Up
Lenses were slightly mobile and vision variable depending on centration. To establish a better centration for
the optical zone, RA was refitted with KeraSoft ® IC.
KeraSoft ® IC Fitting
RE: 8.20/15.00/-6.00/-3.00 x 87 VA 6/6 LE: 8.20/15.00/-2.25/-2.50 x 110 VA 6/6
RA found the acuity more stable with the new KeraSoft ® IC lenses and continued to wear them all day with
comfort.
1 Year Follow Up
KeraSoft ® IC lenses continued to work well with the same specifications.
Topography
RE
LE
The topographies were now more regular, particularly for the right cornea, and RA found she could now wear
disposable contact lenses for swimming.
Summary
Patient with bilateral post LASIK ectasia and right CXL intolerant to RGP lenses
Patient went from:
Poor spectacle acuity of RE: 6/12 and LE: 6/9 with severe ghosting
To:
All day comfortable wear of KeraSoft ® IC lenses with a stable visual acuity of RE: 6/6 and LE: 6/6
RA was able to drive at night again and to perform fully with confidence in her child care profession
UltraVision International Ltd, Commerce Way, Leighton Buzzard, Beds, LU7 4RW
UK Freephone 0800 585115 or +44 (0)1525 381112
email: info@ultravision.co.uk web: www.ultravisiongroup.com