Links to Case Studies:

• Case 1
• Case 2
• Case 3
• Case 4
• Case 5
• Case 6
• Case 7

Case 1: The RK Case

By: Dr. Christine Sindt

History: 37 y/o male, fireman, RK OU 1990

DIL reverse geometry - Series B

Case 2: The PARK Case

By: Dr. Christine Sindt

	CRT Lens

History: 42 y/o female, PARK 3/2000, irregular astigmatism, and sub epi-fibrosis

Case 3: The LASIK Case

By: Dr. Christine Sindt

History: 40 y/o female, LASIK 2000, experiencing regression

+6.00 Focus Night and Day 8.6		+8.00 Acuvue Advance 8.7

+6.00 Focus Night and Day 8.6 with 46.50D 8.8mm GP lens

Case 4: Post LASIK Ectasia Case

By: Dr. Christine Sindt

History: 48 y/o male, LASIK 1999, LRI 2002

Corneo-scleral lens 15mm Jupiter

Patient had epitheliopathy with this lens. Ended up piggybacking. Patient denuded his cornea with the piggy back lens.

Scleral lens design 20mm Jupiter

Case 5

By: Mr. Michael Ward

CC: Blurred, fluctuating vision & glare, OU X 3-6mo

Hx: myopia; LASIK May, 2000. Tried GPs briefly without success; no other CL history.

Pre-operative
Refraction: –OD: -5.75 -2.00 X 100 => 20/20
–OS: -7.00 -2.00 X 043 => 20/20-1, blur
Auto Keratometry:
–OD: 45.37/46.75 X 007
–OS: 45.37/47.00 X 136

No pachymetryin record
Pre-op CVK not available
Enhancement - OS: 11/00 for striae
Referred to Emory Contact Lens Service 1/26/04

Post LASIK Keratectasia

Contact Lens Fitting
Vision, uncorrected
–OD: 20/70
–OS: 20/300
Refraction:
–OD: +0.50 -2.75 X 060 => 20/40
–OS: +2.25 -4.75 X 140 => 20/60
Manual Keratometry:
–OD: 49.9 / 53.9 X 136 2-3+mire distortion
–OS: 55.6 / >60 X 077 2-3 +mire distortion

PPLK RGP Lens 12.5mm

Case 6

By: Mr. Michael Ward

38yoM engineer manager; presents 12/09/03

CC: fluctuating vision during past year following LASIK surgery

Past Ocular History
SCL wearer X many years
–No RGP lens wear
–LASIK, OU, March, 2002
Enhancements at
–OD: 3mo
–OS: 3 & 6mo

Examination
Pachymetry: 495 & 417
SLE:
–Lasik scars; vertical striae
–360° neovascularization, esp. superiorly. OS>OD
Visual acuity with SCL:
–OD: 20/30 PH 20/25
–OS: 20/60 PH 20/40
Refraction:
–OD: -4.25 + 1.75 X 45 => 20/40+1
–OS: -6.50 Sph=> 20/50+1
Manual keratometry:
–OD: 43.8/43.0 X 30 2+dist
–OS: 51.3/47.8 X 147 2+dist

PPLK

Initial Contact Lens Fitting
Mini scleral
–41.50 / 13.5 / -2.50 => 20/20-2
–41.50 / 13.5 / -1.00 => 20/25
Dispensed
–T I&R; 4+1, max 12
–Boston care products

Case 7

By: Mr. Michael Ward

38yoM Engineer, CC decreasing VA, OU

Hx: Keratoconus with RGP wear X 9yrs; No CL X 7 yrs; Tried SCL toric without success

Spectacle correction
–OD 20/20-3
–OS 20/40-2

Initial Topography
44.9/47.4 X 109		46.6/50.5 X 74

Follow-up
Following two lens exchanges, his final lens appt was - 6 weeks later
He was 20/20, OU without reported discomfort, but still experienced some lens awareness
He was instructed to return in 6mo for routine exam

Pt returned 13months later
Hx: had discontinued CL wear 2 months after last visit
Underwent ICRS 7 months ago, OS-only
CC: VA not as good as had expected; wants to try CL again

Left Eye Pre and Post ICRS

Keratometry
–OD: 44.7/47.6 X 113
–OS: 45.1/48.9 X 81
Refraction
–OD: -1.75 -2.00 X 180 =>20/20-1
–OS: Plano -5.00 X 150 =>20/40+2

Contact Lens Fit
No change in CL Rx, OD from initial fitting
Lens parameters, OS
–7.50/9.5(8.4)/-1.50 =>20/30⁺²
Lenses dispensed, rebuilt WT, two f/u appts;
He reported no discomfort, good VA of 20/20^-2, OU

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