Delhi Journal of Ophthalmology

ROSE K2 Contact Lens Rehabilitation in Keratoconic Corneas

Sneha Aggarwal, M Vanathi, Vinay Gupta, Noopur Gupta, Radhika Tandon
Cornea, Lens & Refractive Surgery Services, Dr. R. P. Centre, AIIMS, New Delhi, India.

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

M Vanathi (MD)
Prof of Ophthalmology
Cornea, Lens & Refractive Surgery Services
Dr. R. P. Centre, AIIMS, New Delhi, India
Email : mvanathi.rpc@gmail.com 


Received: 02-APR-2022 Accepted: 09-MAY-2022 Published Online: 25-JUL-2022
DOI: https://dx.doi.org/10.7869/djo.763

Abstract
Purpose: To evaluate the modifications required in ROSE K2 contact lens (CL) fitting in keratoconic corneas.

Methods: A retrospective study with ROSE K2 CL wear in keratoconic corneas was done. Study data noted stage of keratoconus, Uncorrected Visual Acuity (UCVA), Best Spectacle Corrected Visual Acuity (BSCVA) and the Best CL Corrected Visual Acuity (BCLCVA), type of ROSE K2 CL, base curve (BC), overall diameter (OD), edge fit and modifications, Asymmetric Corneal Technology (ACT) & Toric Periphery (TP) design, lens exchanges, and follow ups. Data was analyzed based on the fitting guidelines of ROSE K2 CL [BC Kmean of =5.99mm (group 1), 6.0mm to 6.99mm (group 2), >7.0 Group 3)] and in accordance to the keratoconus staging.

Results: 92 eyes of 64 patients of mean age 22.12 ± 5.57years [(range 11 to 36 years) (males 50, females 14)], which had undergone prior collagen crosslinking, were recruited into the study. Mean logMAR UCVA was 1.01 ± 0.41, mean logMAR BCVA with spectacles was 0.52 ± 0.31 and mean logMAR BCVA with ROSE K2 contact lenses was 0.12 ± 0.09. The difference between the recommended and prescribed CL BC was 0.33 ± 0.34 mm in group 1, 0.19 ± 0.17 mm in group 2 and 0.18 ± 0.16 in group 3.  Edge modification was required in 90%, 58.7% and 45.5% in group 1, 2 & 3 respectively. Eyes of advanced keratoconus required mean change of 0.26 ± 0.24 mm in BC from recommended trial, with a mean difference from K-max of 1.02 ± 0.44 mm, and change in overall lens diameter by 0.21 ± 0.14 mm. 

Conclusion: Advanced corneal ectasias of keratoconus staging IV and with mean K base curve values of < 6 mm require more fitting modifications from recommended manufacturer’s guidelines in order to achieve an optimal CL fitting. Our experience provides guidance on the fitting modifications in parameters required for achieving better customization of ROSE K2 CL in post C3R keratoconic corneas with advanced ectasias. 

Keywords :Keratoconus, Collagen Crosslinking, Rose K2, Contact Lens, Corneal Ectasia, Base Curve, Overall Diameter, Edge Lift