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III. Advanced Contact Lenses > CLEK (M2) > Flashcards

CLEK (M2) Flashcards

1
Q

What is a non-inflammatory corneal ectasia characterized by apical corneal thinning, corneal steepening, visual distortion and central corneal scarring?

A

keratoconus

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2
Q

What did the CLEK study look at?

A

observational study of the natural history of keratoconus

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3
Q

What were the specific aims of the CLEK study?

A
  1. general description of course of keratoconus
  2. factors related to vision in keratoconus
  3. factors related to progression
  4. factors related to scarring
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4
Q

What were the inclusion criteria for the CLEK study?

A
  1. 12 yrs or older
  2. irregular cornea (determined by mires or scissoring)
  3. at least one biomicroscopic sign
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5
Q

What were the biomicroscopic signs related to keratoconus?

A
  1. Vogt’s striae
  2. Fleicher ring of 2mm or more arc
  3. corneal scarring (usually apical)
  4. no other ocular disease
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6
Q

What were the measurements taken at each CLEK exam?

A
  1. VA in high and low contrast
  2. manifest refraction
  3. slit lamp examination
  4. keratometry
  5. topography
  6. habitual CLs fit assessment
  7. quality of life
  8. First definitive apical clearance lens (FDACL)
  9. corneal and fluorescein photography
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7
Q

What is the FDACL?

A

flattest lens in the CLEK diagnostic lens set that vaults the corneal apex

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8
Q

What is the purpose of the FDACL?

A
  1. measures disease severity
  2. measures progression over time
  3. quantitative measures of how steep or flat habitual lenses are fitted
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9
Q

When finding the FDACL, what are the two lenses that get photographed?

A
  1. FDACL lens

2. 0.20mm flatter than FDACL lens

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10
Q

What are the demographics of keratoconus?

A
  1. adolescents and older

2. males slightly more than females

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11
Q

What percent of keratoconic patients in the CLEK study had a corneal transplant?

A

10%

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12
Q

What is the standard of care of fitting keratoconics?

A

fitting flat

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13
Q

What factors had the largest impact on vision related quality of life?

A
  1. visual acuity

2. corneal curvature

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14
Q

What were the longitudinal findings of the CLEK study as relates to visual acuity?

A
  1. slow dec in VA at both high and low contrast, with low acuity dec more rapidly
  2. steeper corneas and/or corneal scarring were predictive of inc loss of best corrected VA
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15
Q

What were the longitudinal findings of the CLEK study as relates to corneal curvature?

A
  1. slow inc in corneal curvature

2. younger age and poorer high contrast manifest refraction VA predicted inc rate of change

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16
Q

What were the longitudinal findings of the CLEK study as relates to corneal scarring?

A

Predictive:

  1. younger age
  2. corneal staining
  3. steeper baseline corneal curvature
  4. CL wearer
  5. poor low contrast VA
17
Q

What were the translations to be taken into clinical practice from the CLEK study?

A
  1. FDACL (bracket for endpoint in the fit process)
  2. avoid extremes (diff than apical touch or clearance)
  3. small minority of people progress quickly
  4. small minority has transplant
  5. public health significance disproportionate to disease severity

III. Advanced Contact Lenses (16 decks)

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