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Refraction, Lensa contact and Low Vision subdivision
Department of Ophthalmology Medical Faculty of Andalas University
Dr.M.Djamil Hospital Padang, West Sumatra, Indonesia

Introduction: Keratoconus is a noninflammatory ectasia characterized by thinning and
subsequent protrusion of the corneal apex. Frequent spectacle prescription changes are
common. Rigid Gas Permeable (RGP) is one of recommended management for keratoconus
eye, thus good fitting RGP is important in successfull management of keratoconus with
contact lens.
Objective: A proper management of fitting RGP in keratoconus eye to achieve good outcome
in contact lens treatment.
Methods: Optimal basecurve required instrument keratometer. Modern autokeratometer can
detect corneal distortion with readings can be as steep as 4-5 mm, but manual keratometer
measures only the central 3 mm of the cornea. In a very steep cornea, keratometer reading
may exceed the number on the dial. In this case, enhancenment prosedure is required to
extend the range of measurement, a +1.25D or a +2.25 D trial lens can be taped to the face of
the keratometer, in the center of the ligh ted circle and over the hole. In moderate and
advanced cases, minimal central touch and minimal intermediate compression should be
attained. This is a three-point touch fitting relationship with minimal central touch and two
zones of peripheral support.
Result: The lens should be designed with a peripheral curve system that permits good
circulation of the tear film under the lens, without excessive edge lift. Ideally, the lens fit
should exhibit minimal apical touch or apical clearance, no excessive areas of tear or debris
pooling beneath the optic zone, good circulation of the tear film under the lens, good stability
and comfort.