The Effect of YK Lens on Keratoconus

Ji-Eun Lee1, Jong Soo Lee1, Young Ki Park2 Department of Ophghlamology, College of Medicine, Pusan National University1, Park Young Ki Eye Center2

Purpose

To introduce fitting characteristics and to evaluate clinical efficacy and safety of multicurve YK lens for keratoconus

Methods

Patients

129 eyes

Patients with first prescription 77eyes Patients having difficulties with their previous lenses 52eyes

Keratoconus was diagnosed by Rabinowitz indices on topography or by characteristic objective findings

Methods

Lens characteristics
Base curve
Peripheral curve 1

Peripheral curve 2

Dk = 4710-11 center thickness = 0.1mm (-10D)

(Peripheral curve 3) Edge Multiple Peripheral Curves 5 curves in steeper BC Changing Parameters is Easy

YK1 Total Dia 8.7mm Power BCR OZD PCR1 PZW1 PCR2 PZW2 PCR3 PZW3 Edge EW -20.00 5.00 4.7 5.50 0.5 6.00 0.5 7.00 0.6 9.20 0.4

YK2 Total Dia Power BCR OZD PCR1 PZW1 PCR2 PZW2 PCR3 PZW3 Edge EW 8.7mm -20.00 5.20 4.7 5.70 0.5 6.20 0.5 7.20 0.6 9.40 0.4

YK24 Total Dia Power BCR OZD PCR1 PZW1 PCR2 PZW2 8.7mm -4.00 7.50 6.5 8.30 0.4 9.30 0.4

YK25 Total Dia Power BCR OZD PCR1 PZW1 PCR2 PZW2 8.7mm -4.00 7.60 6.5 8.40 0.4 9.40 0.4

Edge EW

11.00 0.3

Edge EW

11.10 0.3

Total 25 Size: 8.7mm BCR: 0.1mm increment except first 3

BCR-OZD relationship Smaller OZD Steeper Peripheral Curves

Methods

Fitting methods
amount of Astigmatisms

1. Initial BCR flat K minus 1/3 of the 2. With fluorescein pattern by changing Trial Lenses a. Minimal Apical Touch b. Mid Peripheral Bearing c. Edge 3. Centering 4. Movement :1-1.5mm 5. Overrefraction : Prescribe diopters

Methods

Case

K : 7.86/7.51 Eccentricity : 0.60 TR (YK25) =Final Lens

Methods

Modification of trial lenses

1. Determine Central BC First 2. If Edge High Lower type (-1,-2) If Edge Low Higher type (+1,+2) 3. Oval Cone Enlarge OZD (0.5-1.0mm) 4. Decenter - Enlarge OZD (0.5-1.0mm) 5. High Inferior Edge Lift Steepen BC or Enlarge OZD

Methods

Case decrease in PC

K : 5.63/5.25 Eccentricity : 0.32 TR (YK 1) Final Lens

Total Diameter : 8.6mm 2nd : - 0.5 mm 3rd : 0.7 mm edge : - 2.0 mm

Results
50 45 40 35 30 25 20 15 10 5 0 4 6 8 10 12 14 16 18 Wearing time

20/40 or better : 82.1% 2 Snellen lines :93.8% Avr 12.2 hours (4-18) better than comfortable : 90%
No. of eyes

Wearing time

No. of eyes

Visual acuity

70 60 50 40 30 20 10 0 Very irritating Irritating Mildly irritating Comfort Comfortable Very comfortable

Comfort

Results

Keratoconus progression between before and after fitting

Changes of averages of Sim-K First definite apical clearance lens significant progression was found
Before fitting After fitting P value
53.125.49

No

Sim-Kmx (D) a Sim-Km (D) in Flatness (D)

55.725.2 5 46.626. 21 2.983.3 1

0.21 0.10 0.34

47.754. 23 2.853.02

Conclusions

YK lens could provide

successful visual outcome with comfort and with no significant aggrevating changes or significant progression of disease

in keratoconus