Modern clinical use of Mini- scleral contact lenses WCO VI – Boston 2010. Dr Langis Michaud OD...
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Modern clinical use of Mini-scleral contact lenses WCO VI – Boston 2010. Dr Langis Michaud OD M.SC. FAAO (Dipl) Associate Professor
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Transcript of Modern clinical use of Mini- scleral contact lenses WCO VI – Boston 2010. Dr Langis Michaud OD...
Modern clinical use of Mini-scleral contact lenses WCO VI – Boston 2010.
Dr Langis Michaud OD M.SC. FAAO (Dipl)
Associate Professor
Disclosure The author of this poster have received
research funding from Laboratoires Blanchard (Sherbrooke, Québec)
There is no other financial interest in the subject matter of this poster.
Classification ( Dr Sindt, o.d.) Corneo-scleral contact lenses : 12.0 -13.5 mm
Semi-scleral lenses : 13.6 –14.9 mm
Mini-scleral: 15.0 – 18.0 mm
Scleral lenses 18.1- 24.0 mm
Mini-scleral lens modern usage Graft vs Host disease (GVH) Atopic keratoconjunctivitis Corneal disorders /surface diseases / dystrophies Corneal ectasia (KC/PMD) Post-graft Post-refractive surgery Intolerance to other modalities High refractive errors (myopia, astigmatism)
Mini-scleral applications
Patient with corneal dystrophy (Groenouw I) OD and a corneal graft OS
Clinical advantages of Mini-scleral lenses To improve visual acuity
To increase lenses comfort and stability
To favor oxygen transmissibility
To help to restore ocular health Valuable option for chronic ocular surface diseases
Reasons for failure Handling too difficult (40%)
Age, dexterity Discomfort (25%)
Becomes a symptom of a bad fit…. Seal off of the conjunctiva or the limbal area
No better visual outcome (15%) Vision problem not related to corneal surface
Cost (12%) Other systemic causes – toxicity to solutions,
intolerance, etc (8%)
Photo gallery
Corneal scarring secondary to a chronic inflammation of the cornea
Uncorrected V.A. 6/40BCVA with Mini-scleral c.l. 6/7,5
Fitted with a MSD 15,8 lens / DD profile
The best alternative Acculens – Maxim 4 and 5 (Denver, Colorado)
The easiest mini-scleral lens to fit nowadays (diam from16 to 17,5 mm)
Comfortable – predictable
Extended range of parameters available
Conclusion Mini-scleral lenses are part of modern
treatment of corneal ectasia, post-surgery corneal restoration and chronic ocular surface disorders.
Other applications include refractive errors or intolerance with other type of contact lenses
Relatively easy to fit with modern designs Learning curve exists however
The last word To fit Mini-Scleral lenses is a rewarding
process
Better results are achieved over time
Mini-scleral lenses should not be considered the last option any more….
More info: www.sclerallens.org
Author biography OD- U de Montréal (1986) M.SC. – U de Montréal (1998) 3rd cycle- short program ENAP
Montréal - Public health (2006)
Associate Professor (2001-…)École d’optométrie de l’Université de Montréal
Head- contact lens department- clinical studies in contact lenses
Fellow American Academy of Optometry (1998)
Diplomate- Cornea and Contact lenses (1995)
Publications
list available upon request
poster and lectures at ARVO, AAO and AOA, nationally and internationally
Research interests
Cornea, anterior segment
Specialty contact lenses
Fabry’s disease and MPS
Contact
514.343.6111 ext 8945
