glazmagThe EYE ГЛАЗThe EYE GLAZ2222-44082686-8083Академия медицинской оптики и оптометрии10.33791/2222-4408-2022-1-34-41glazmag-299Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESКоррекция иррегулярной формы роговицы после рефракционных операций склеральной линзой по технологии EyePrintPROTM (клинический случай)Restoration of Ocular Surface and Correction of Irregular Corneas Caused by Radial Keratotomy Using EyePrintPROTM Technology (Case Report)ФорбсВ. А.ForbesV. A.

Форбс Валерия А., магистр оптометрии

33180, Флорида, Майями, 2627 NE 203 Стрит, офис 116

Valeriya A. Forbes, MScOptom

2627 NE 203rd Str., Suite 116, Miami, FL 33180

forbesvalery@aol.comБошникЭ. Л.BoschniсkE. L.

Бошник Эдвард Л., доктор оптометрии

33173, Флорида, Майями, 7800 SW 87 Авеню, офис B-270

Edward L. Boschniсk, OD

7800 SW 87 Ave., Suite B-270, Miami, FL 33173

globalvisionrehabcenter@gmail.comИнститут контактной коррекции МайямиСоединённые Штаты АмерикиMiami Contact Lens InstituteUnited StatesГлобальный центр реабилитации зренияСоединённые Штаты АмерикиGlobal Vision Rehabilitation CenterUnited States2022020420222413441Copyright © Академия медицинской оптики и оптометрии, 20222022Академия медицинской оптики и оптометрииАкадемия медицинской оптики и оптометрииhttps://www.theeyeglaz.com/jour/about/submissions#copyrightNoticehttps://www.theeyeglaz.com/jour/article/view/299

Актуальность. Количество рефракционных операций по коррекции близорукости растет – растет и количество осложнений. Одним из таких осложнений, приводящих к прогрессирующей потере зрения, является ятрогенная эктазия роговицы, которая трудно поддается коррекции и зачастую делает пациентов молодого возраста нетрудоспособными.Цель: показать возможности коррекции такого рода осложнений с помощью склеральной линзы по технологии EyePrintProTM.Материалы и методы. Клинический случай описывает коррекцию ятрогенной прогрессирующей дальнозоркости склеральными контактными линзами по технологии EyePrintPROTM у 52‑летнего белого мужчины. Пациенту было проведено несколько рефракционных операций, включая радиальную кератотомию, Lasik и кросс-линкинг, которые привели к возникновению периферической эктазии роговицы и прогрессирующей дальнозоркости. Ранее ему были подобраны склеральные линзы, однако они не обеспечивали комфорта, вызывали гиперемию и ощущение инородного тела. Пациенту провели полное офтальмологическое обследование, включая специальные методики для подбора и расчета склеральных контактных линз. Линзы изготовили по технологии EyePrintProTM с использованием слепков передней поверхности глаза. Также проведен анализ публикаций, посвященных ятрогенным кератоэктазиям, на ресурсах PubMed, eLibrary, Cyberleninka, Crossref metadata search и др.Результаты и обсуждение. Благодаря технологии EyePrintPROTM удалось обеспечить высокую остроту зрения в изготовленных склеральных линзах и комфорт при их ношении: острота зрения повысилась на OD с 0,16 до 1,0 и на OS с 0,4 до 1,0. Несмотря на наличие пингвекулы на левом глазу, удалось добиться адекватной посадки, продемонстрирована хорошая конгруэнтность линз с помощью оптической когерентной томографии (ОКТ) переднего отрезка глаза. В обсуждении дается анализ причин (по данным литературы), приводящих к возникновению ятрогенных эктазий, и описание особенностей лечения и коррекции данной патологии.Выводы. Таким образом, склеральные линзы, изготовленные по слепку, являются наиболее предпочтительными у пациентов с выраженным иррегулярным профилем роговицы и склеры.

Background. The number of laser refractive surgeries to treat myopia is growing, and so does the number of complications. One of these complications, leading to progressive loss of vision, is iatrogenic corneal ectasia, which is difficult to correct and often causes work incapacity.Purpose. The purpose of this case report is to demonstrate the possibilities of correcting iatrogenic corneal ectasia with contact lenses utilizing EyePrintPROTM technology.Materials and methods. A clinical case describes the correction of iatrogenic progressive hyperopia with EyePrintPROTM contact lenses in a 52-year-old white male. The patient underwent several refractive surgeries, including Radial Keratotomy, Lasik and Cross-Linking, which resulted in peripheral corneal ectasia and progressive hyperopia. Previously fitted scleral lenses did not provide comfort and caused hyperemia and a foreign body sensation. The patient underwent a complete ophthalmological examination, including special examinations required for calculation of contact lens parameters. The EyePrintPROTM lenses were made by taking an impression of the anterior ocular surface. In addition, an analysis of literature on corneal ectasia available on PubMed, eLibrary, Cyberleninka, Crossref metadata search and other resources was carried out.Results and discussion. Thanks to EyePrintPROTM technology, it was possible to restore visual acuity and comfort: visual acuity increased from 0.16 to 1.0 in OD and from 0.4 to 1.0 in OS. Despite the presence of a pinguecula in the left eye, an adequate fit was achieved as demonstrated by optical coherence tomography (OCT) of the anterior segment of the eye. The discussion section provides a literature-based analysis of the causes leading to the occurrence of iatrogenic ectasia and expands on specifics of treatment of this pathology.Conclusion. Impressionbased contact lenses may be a preferred choice for patients with corneal and scleral irregularities.

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The authors declare that there are no conflicts of interest present.