The Experts below are selected from a list of 768 Experts worldwide ranked by ideXlab platform
Perry Rosenthal - One of the best experts on this subject based on the ideXlab platform.
-
fluid ventilated gas permeable Scleral Contact Lens is an effective option for managing severe ocular surface disease and many corneal disorders that would otherwise require penetrating keratoplasty
Eye & Contact Lens-science and Clinical Practice, 2005Co-Authors: Perry Rosenthal, Amy CroteauAbstract:Purpose.To examine the diagnostic indications and relative merits of a fluid-ventilated, gas-permeable Scleral Lens for improving vision impaired by irregular astigmatism and for providing a therapeutic environment for managing severe ocular surface disease.Methods.After a review of Scleral Lens dev
-
treatment of persistent corneal epithelial defect with extended wear of a fluid ventilated gas permeable Scleral Contact Lens
American Journal of Ophthalmology, 2000Co-Authors: Janis Cotter, Perry Rosenthal, Jules L BaumAbstract:Abstract PURPOSE: To report treatment of persistent corneal epithelial defects unresponsive to other therapies by extended wear of a fluid-ventilated gas-permeable Scleral Contact Lens. METHODS: In this retrospective study, 14 eyes of 13 consecutive patients referred for the treatment of persistent corneal epithelial defects that failed to heal with conventional therapies or developed epithelial defects after penetrating keratoplasty for persistent corneal epithelial defects were fitted with an extended-wear gas-permeable Scleral Lens. These included seven eyes of six patients with Stevens-Johnson syndrome and seven eyes of seven patients who did not have Stevens-Johnson syndrome. Twelve eyes had undergone recent penetrating keratoplasty. All 14 eyes were fitted with a gas-permeable Scleral Contact Lens designed to avoid the intrusion of air bubbles under its optic. An antibiotic and corticosteroid were added to the Lens fluid reservoir or instilled before each Lens insertion in 12 of 14 eyes. The Lenses were worn continuously except for brief periods of removal for purposes of cleaning, replacement of the Lens fluid reservoir, and examination and photography of the cornea. RESULTS: Five of the seven persistent corneal epithelial defects associated with Stevens-Johnson syndrome healed. The persistent corneal epithelial defects of four of these eyes re-epithelialized within 7 days, and a fifth healed in 27 days of gas-permeable Scleral Lens extended wear. A sixth persistent corneal epithelial defect that failed to heal initially re-epithelialized after a subsequent penetrating keratoplasty and gas-permeable Scleral Lens extended wear. The seventh eye healed after 3 days of gas-permeable Scleral Lens extended wear, but the persistent corneal epithelial defect subsequently recurred. Three of seven non–Stevens-Johnson syndrome persistent corneal epithelial defects re-epithelialized within 36 hours, 6 days, and 36 days, respectively. Of the six (six of 14) persistent corneal epithelial defects that failed to heal with a gas-permeable Scleral Lens extended wear, one subsequently healed after multiple amniotic membrane grafts. Microbial keratitis occurred in four eyes (four of 14) and graft failure in one eye, all of which required repeat penetrating keratoplasty. CONCLUSION: Extended wear of an appropriately designed gas-permeable Scleral Contact Lens was effective in promoting the healing of persistent corneal epithelial defects in some eyes that failed to heal after other therapeutic measures. Re-epithelialization appears to be aided by a combination of oxygenation, moisture, and protection of the fragile epithelium afforded by the Scleral Lens. However, microbial keratitis represents a significant risk.
-
gas permeable Scleral Contact Lens therapy in ocular surface disease
American Journal of Ophthalmology, 2000Co-Authors: Janis Cotter, Perry Rosenthal, Tatiana Romerorangel, Panagiota Stavrou, Stefanos Baltatzis, Stephen C FosterAbstract:Abstract PURPOSE: To describe the therapeutic benefits of nonfenestrated gas-permeable Scleral Contact Lenses in the management of patients with ocular surface disease. METHODS: The charts of 49 consecutive patients (76 eyes) with ocular surface disease whose management included the use of gas-permeable Scleral Contact Lenses were reviewed. We also developed a questionnaire to assess the impact of Lens wear on subjective aspects of activities of daily living. RESULTS: The mean age of the 49 patients was 44.6 years (range, 3 to 87 years); 31 patients were female and 18 were male. The most common indication for fitting of the Lenses was Stevens-Johnson syndrome (54 [71%] of the 76 eyes). Other indications included ocular cicatricial pemphigoid, exposure keratitis, toxic epidermal necrolysis, postherpetic keratitis, congenital deficiency of meibomian glands, superior limbal keratoconjunctivitis, Sjogren syndrome, and inflammatory corneal degeneration. The mean follow-up was 33.6 months (range, 2 to 144 months). Improvement in best-corrected visual acuity (defined as a gain of 2 or more Snellen lines) was observed in 40 (53%) of the eyes. In eight (53%) of the 15 eyes with active corneal epithelial defects at the time of Lens fitting, the defects healed, whereas in the remaining seven eyes the corneal epithelial defects remained unchanged. Forty-five (92%) of the 49 patients reported improvement in their quality of life as a result of reduction of photophobia and discomfort. The mean wearing time of the gas-permeable Scleral Contact Lenses was 13.7 hours per day (range, 4 to 18 hours). Many patients had preparatory surgical procedures before Lens fitting (for example, punctal occlusion or mucous membrane grafting), and some had visual rehabilitation surgical procedures (for example, keratoplasty and/or cataract surgery) after Lens fitting. CONCLUSIONS: Gas-permeable Scleral Contact Lens wear provides an additional effective strategy in the surface management and visual rehabilitation of patients with severe ocular surface disease.
Stephen C Foster - One of the best experts on this subject based on the ideXlab platform.
-
gas permeable Scleral Contact Lens therapy in ocular surface disease
American Journal of Ophthalmology, 2000Co-Authors: Janis Cotter, Perry Rosenthal, Tatiana Romerorangel, Panagiota Stavrou, Stefanos Baltatzis, Stephen C FosterAbstract:Abstract PURPOSE: To describe the therapeutic benefits of nonfenestrated gas-permeable Scleral Contact Lenses in the management of patients with ocular surface disease. METHODS: The charts of 49 consecutive patients (76 eyes) with ocular surface disease whose management included the use of gas-permeable Scleral Contact Lenses were reviewed. We also developed a questionnaire to assess the impact of Lens wear on subjective aspects of activities of daily living. RESULTS: The mean age of the 49 patients was 44.6 years (range, 3 to 87 years); 31 patients were female and 18 were male. The most common indication for fitting of the Lenses was Stevens-Johnson syndrome (54 [71%] of the 76 eyes). Other indications included ocular cicatricial pemphigoid, exposure keratitis, toxic epidermal necrolysis, postherpetic keratitis, congenital deficiency of meibomian glands, superior limbal keratoconjunctivitis, Sjogren syndrome, and inflammatory corneal degeneration. The mean follow-up was 33.6 months (range, 2 to 144 months). Improvement in best-corrected visual acuity (defined as a gain of 2 or more Snellen lines) was observed in 40 (53%) of the eyes. In eight (53%) of the 15 eyes with active corneal epithelial defects at the time of Lens fitting, the defects healed, whereas in the remaining seven eyes the corneal epithelial defects remained unchanged. Forty-five (92%) of the 49 patients reported improvement in their quality of life as a result of reduction of photophobia and discomfort. The mean wearing time of the gas-permeable Scleral Contact Lenses was 13.7 hours per day (range, 4 to 18 hours). Many patients had preparatory surgical procedures before Lens fitting (for example, punctal occlusion or mucous membrane grafting), and some had visual rehabilitation surgical procedures (for example, keratoplasty and/or cataract surgery) after Lens fitting. CONCLUSIONS: Gas-permeable Scleral Contact Lens wear provides an additional effective strategy in the surface management and visual rehabilitation of patients with severe ocular surface disease.
Roger J. Buckley - One of the best experts on this subject based on the ideXlab platform.
-
Development of the gas-permeable impression-moulded Scleral Contact Lens. A preliminary report.
Acta Ophthalmologica, 2009Co-Authors: C. J. Lyons, Roger J. Buckley, K. Pullum, N. SappAbstract:Although superceded by corneal hard and soft Contact Lenses for the correction of simple refractive error, the Scleral Lens still has numerous medical applications in modern ophthalmological practice. However, a major problem with Scleral Lenses has been the limited wearing time due to corneal occlusion and consequent hypoxia. We present two alternative methods for the production of moulded gas permeable Scleral Contact Lenses.
-
Scleral Contact Lenses: the expanding role.
Cornea, 2005Co-Authors: Kenneth W. Pullum, Mark A Whiting, Roger J. BuckleyAbstract:Purpose:The purpose of this study was to describe the current indications for Scleral Contact Lens (ScCL) management at Moorfields Eye Hospital, London.Methods:A database of 1003 patients (1560 eyes) seen between September 1999 and May 2003, either assessed for an ScCL trial or to follow up previous
-
a study of 530 patients referred for rigid gas permeable Scleral Contact Lens assessment
Cornea, 1997Co-Authors: Kenneth W. Pullum, Roger J. BuckleyAbstract:PURPOSE The purpose of this study was to analyse the current application of Scleral Contact Lenses in two specialist centres. METHODS The case notes of 530 patients assessed for fitting or refitting with rigid gas permeable (RGP) Scleral Lenses were retrospectively analysed to determine the indication for Contact Lenses and the outcome. Scleral Lenses had been offered as a conservative management option in suitable cases for a variety of visual and medical indications. RESULTS Various types of primary corneal ectasia, ranging from low grade to advanced, including keratoconus, keratoglobus, and pellucid marginal degeneration, formed 53.0% of the total referred for assessment. The other principal indications for Contact Lenses were corneal transplant (15.8%), aphakia (10.3%), high myopia (8.9%), and various ocular surface disorders (8.2%). Sixty percent continued to use Scleral Lenses, 42.9% RGP, and 17.1% polymethylmethacrylate Lenses. Twenty-two percent discontinued Scleral Lens wear or failed a trial of Scleral Lenses, with 9.3% in progress at the time of assessment and 8.7% lost to follow-up. CONCLUSIONS In the authors' opinion, Scleral Lenses have retained their traditional role in the management of complex ametropia and ocular surface disease. That role has been further enhanced by the application of gas permeable materials.
-
Medical applications of Scleral Contact Lenses: 2. Gas-permeable Scleral Contact Lenses.
Cornea, 1995Co-Authors: Donald T.h. Tan, Kenneth W. Pullum, Roger J. BuckleyAbstract:The indications and outcome of the wear of gas-permeable (GP) Scleral Contact Lenses in 118 eyes of 85 patients attending a Scleral Contact Lens Clinic during a 5-year period from July 1988 to June 1993 were analysed. Ninety-nine eyes (83.9%) were originally fitted with PMMA Lenses and were subseque
-
Medical applications of Scleral Contact Lenses: 1. A retrospective analysis of 343 cases.
Cornea, 1995Co-Authors: Donald T.h. Tan, Kenneth W. Pullum, Roger J. BuckleyAbstract:The medical indications for, and outcome of Scleral Contact Lens wear in 517 eyes of 343 patients attending a Scleral Contact Lens Clinic during a 5-year period from July 1988 to June 1993 were analysed. Keratoconus was the most common condition requiring Scleral Lens wear (36.2%), followed by aphakia (18.4%), postpenetrating keratoplasty (12.0%), irregular astigmatism secondary to corneal disease (12.0%), high myopia (12.8%), and ocular surface disorders (6.4%). The main indication was visual (85.8%), whereas therapeutic indications accounted for 8.2% of cases. Seventy-six percent of cases had previously failed with other types of Contact Lenses. The majority of patients were initially fitted with impression moulded polymethylmethacrylate (PMMA) Lenses (90.5%); other Scleral Lens types included preformed PMMA Lenses, preformed high Dk gas-permeable (GP) Lenses, and a GP/PMMA hybrid Scleral Lens design. Initial Scleral Lens fitting was successful in 93.2% of cases, and 71% remained successful with a mean duration of 11.8 years' follow-up. Complications included corneal vascularisation (13.3% of eyes), episodes of corneal oedema (7.4%), corneal abrasion (3.1%), and giant papillary conjunctivitis (1.7%). In addition to 19 eyes initially fitted with GP Lenses, there were 99 eyes initially wearing PMMA Lenses that were subsequently refitted with GP Scleral Lenses.
Tatiana Romerorangel - One of the best experts on this subject based on the ideXlab platform.
-
gas permeable Scleral Contact Lens therapy in ocular surface disease
American Journal of Ophthalmology, 2000Co-Authors: Janis Cotter, Perry Rosenthal, Tatiana Romerorangel, Panagiota Stavrou, Stefanos Baltatzis, Stephen C FosterAbstract:Abstract PURPOSE: To describe the therapeutic benefits of nonfenestrated gas-permeable Scleral Contact Lenses in the management of patients with ocular surface disease. METHODS: The charts of 49 consecutive patients (76 eyes) with ocular surface disease whose management included the use of gas-permeable Scleral Contact Lenses were reviewed. We also developed a questionnaire to assess the impact of Lens wear on subjective aspects of activities of daily living. RESULTS: The mean age of the 49 patients was 44.6 years (range, 3 to 87 years); 31 patients were female and 18 were male. The most common indication for fitting of the Lenses was Stevens-Johnson syndrome (54 [71%] of the 76 eyes). Other indications included ocular cicatricial pemphigoid, exposure keratitis, toxic epidermal necrolysis, postherpetic keratitis, congenital deficiency of meibomian glands, superior limbal keratoconjunctivitis, Sjogren syndrome, and inflammatory corneal degeneration. The mean follow-up was 33.6 months (range, 2 to 144 months). Improvement in best-corrected visual acuity (defined as a gain of 2 or more Snellen lines) was observed in 40 (53%) of the eyes. In eight (53%) of the 15 eyes with active corneal epithelial defects at the time of Lens fitting, the defects healed, whereas in the remaining seven eyes the corneal epithelial defects remained unchanged. Forty-five (92%) of the 49 patients reported improvement in their quality of life as a result of reduction of photophobia and discomfort. The mean wearing time of the gas-permeable Scleral Contact Lenses was 13.7 hours per day (range, 4 to 18 hours). Many patients had preparatory surgical procedures before Lens fitting (for example, punctal occlusion or mucous membrane grafting), and some had visual rehabilitation surgical procedures (for example, keratoplasty and/or cataract surgery) after Lens fitting. CONCLUSIONS: Gas-permeable Scleral Contact Lens wear provides an additional effective strategy in the surface management and visual rehabilitation of patients with severe ocular surface disease.
Janis Cotter - One of the best experts on this subject based on the ideXlab platform.
-
treatment of persistent corneal epithelial defect with extended wear of a fluid ventilated gas permeable Scleral Contact Lens
American Journal of Ophthalmology, 2000Co-Authors: Janis Cotter, Perry Rosenthal, Jules L BaumAbstract:Abstract PURPOSE: To report treatment of persistent corneal epithelial defects unresponsive to other therapies by extended wear of a fluid-ventilated gas-permeable Scleral Contact Lens. METHODS: In this retrospective study, 14 eyes of 13 consecutive patients referred for the treatment of persistent corneal epithelial defects that failed to heal with conventional therapies or developed epithelial defects after penetrating keratoplasty for persistent corneal epithelial defects were fitted with an extended-wear gas-permeable Scleral Lens. These included seven eyes of six patients with Stevens-Johnson syndrome and seven eyes of seven patients who did not have Stevens-Johnson syndrome. Twelve eyes had undergone recent penetrating keratoplasty. All 14 eyes were fitted with a gas-permeable Scleral Contact Lens designed to avoid the intrusion of air bubbles under its optic. An antibiotic and corticosteroid were added to the Lens fluid reservoir or instilled before each Lens insertion in 12 of 14 eyes. The Lenses were worn continuously except for brief periods of removal for purposes of cleaning, replacement of the Lens fluid reservoir, and examination and photography of the cornea. RESULTS: Five of the seven persistent corneal epithelial defects associated with Stevens-Johnson syndrome healed. The persistent corneal epithelial defects of four of these eyes re-epithelialized within 7 days, and a fifth healed in 27 days of gas-permeable Scleral Lens extended wear. A sixth persistent corneal epithelial defect that failed to heal initially re-epithelialized after a subsequent penetrating keratoplasty and gas-permeable Scleral Lens extended wear. The seventh eye healed after 3 days of gas-permeable Scleral Lens extended wear, but the persistent corneal epithelial defect subsequently recurred. Three of seven non–Stevens-Johnson syndrome persistent corneal epithelial defects re-epithelialized within 36 hours, 6 days, and 36 days, respectively. Of the six (six of 14) persistent corneal epithelial defects that failed to heal with a gas-permeable Scleral Lens extended wear, one subsequently healed after multiple amniotic membrane grafts. Microbial keratitis occurred in four eyes (four of 14) and graft failure in one eye, all of which required repeat penetrating keratoplasty. CONCLUSION: Extended wear of an appropriately designed gas-permeable Scleral Contact Lens was effective in promoting the healing of persistent corneal epithelial defects in some eyes that failed to heal after other therapeutic measures. Re-epithelialization appears to be aided by a combination of oxygenation, moisture, and protection of the fragile epithelium afforded by the Scleral Lens. However, microbial keratitis represents a significant risk.
-
gas permeable Scleral Contact Lens therapy in ocular surface disease
American Journal of Ophthalmology, 2000Co-Authors: Janis Cotter, Perry Rosenthal, Tatiana Romerorangel, Panagiota Stavrou, Stefanos Baltatzis, Stephen C FosterAbstract:Abstract PURPOSE: To describe the therapeutic benefits of nonfenestrated gas-permeable Scleral Contact Lenses in the management of patients with ocular surface disease. METHODS: The charts of 49 consecutive patients (76 eyes) with ocular surface disease whose management included the use of gas-permeable Scleral Contact Lenses were reviewed. We also developed a questionnaire to assess the impact of Lens wear on subjective aspects of activities of daily living. RESULTS: The mean age of the 49 patients was 44.6 years (range, 3 to 87 years); 31 patients were female and 18 were male. The most common indication for fitting of the Lenses was Stevens-Johnson syndrome (54 [71%] of the 76 eyes). Other indications included ocular cicatricial pemphigoid, exposure keratitis, toxic epidermal necrolysis, postherpetic keratitis, congenital deficiency of meibomian glands, superior limbal keratoconjunctivitis, Sjogren syndrome, and inflammatory corneal degeneration. The mean follow-up was 33.6 months (range, 2 to 144 months). Improvement in best-corrected visual acuity (defined as a gain of 2 or more Snellen lines) was observed in 40 (53%) of the eyes. In eight (53%) of the 15 eyes with active corneal epithelial defects at the time of Lens fitting, the defects healed, whereas in the remaining seven eyes the corneal epithelial defects remained unchanged. Forty-five (92%) of the 49 patients reported improvement in their quality of life as a result of reduction of photophobia and discomfort. The mean wearing time of the gas-permeable Scleral Contact Lenses was 13.7 hours per day (range, 4 to 18 hours). Many patients had preparatory surgical procedures before Lens fitting (for example, punctal occlusion or mucous membrane grafting), and some had visual rehabilitation surgical procedures (for example, keratoplasty and/or cataract surgery) after Lens fitting. CONCLUSIONS: Gas-permeable Scleral Contact Lens wear provides an additional effective strategy in the surface management and visual rehabilitation of patients with severe ocular surface disease.