Clinical Report: Troubleshooting with Piggyback Lenses

Overview

This report discusses two cases of keratoconus patients who were unsuccessful with scleral lenses but achieved comfort and stability using piggybacked corneal GP lenses. The findings highlight the importance of tailored lens fitting strategies for improved patient outcomes.

Background

Keratoconus is a progressive eye disease that often necessitates the use of specialty contact lenses for visual rehabilitation. Scleral lenses have become a common solution, but not all patients achieve success with them. Understanding alternative fitting strategies, such as piggybacking, is crucial for optimizing comfort and visual performance in these patients.

Data Highlights

No numerical data available in the article.

Key Findings

• Two keratoconus patients failed with scleral lenses but succeeded with piggybacked GP lenses.
• Daily disposable silicone hydrogel lenses are recommended for piggybacking to enhance comfort and reduce hypoxic stress.
• Custom soft lenses may be necessary for severe keratoconus cases to achieve adequate sagittal depth.
• Hydrogen peroxide care systems are advised for GP lenses to prevent interactions with soft lens care products.
• Fitting larger-diameter GP lenses can improve stability and comfort for keratoconus patients.

Clinical Implications

Clinicians should consider piggyback systems as a viable option for keratoconus patients who do not tolerate scleral lenses. Emphasizing daily disposable silicone hydrogel lenses can simplify lens care and enhance patient comfort.

Conclusion

The use of piggybacked GP lenses presents a practical solution for keratoconus patients struggling with scleral lenses, highlighting the need for individualized fitting approaches in specialty lens care.

References

1. Koppen C, et al, Am J Ophthalmol, 2018 -- Scleral Lenses Reduce the Need for Corneal Transplants in Severe Keratoconus
2. van der Worp E, et al, Cont Lens Anterior Eye, 2021 -- Variation in sag values in daily disposable, reusable and toric soft contact lenses
3. Contact Lens Spectrum — contact lens case reports
4. Contact Lens Spectrum — Contact Lens Case Reports
5. Contact Lens Spectrum — Contact Lens Case Reports
6. Second Global Consensus on Keratoconus
7. Long-term Effectiveness of Scleral Lens Treatment in Keratoconus
8. https://gpli.info/pdf/pearl-fitting-guide.pdf