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av Irene Frantzis 10 år siden

903

Central topic

Rigid Gas Permeable (RGP) lenses offer various fitting parameters to address different eye conditions, including keratoconus and myopia. Thinner lenses are more flexible but can become distorted when worn on keratoconic eyes, while thicker lenses are heavier and more prone to dropping.

Central topic

Center Thickness, order as TAP

Thinner lens more flexible, will get distorted on keratoconic eye

Thicker lens heavier, more likely to drop

RGP Fitting Parameters

Tear Lens

Flat BC to K for lid held position
Steep BC to K relationship secures centered lens

Peripheral Curve Radius

Edge Pattern
Excessive Edge Lift

Solution: Steepen PC

Minimal Edge Lift

Solution: Flatten PC

3 CR= 2CR + 1.5 mm
2 CR= BCR + 1 mm

Total Diameter

Vertical Aperture Size
Diameter should be at least smaller than vertical aperture
HVID
HVID -2.5 mm

If too small, increase

If too large, decrease

BC Radius

Problem: Too Flat
Apical Touch

Decrease BC radius/ Steepen BC radius

Problem: Too Steep
Apical Clearance

increase BC radius/ Flatten BC radius

Material

Peripheral Curve Width

3CW= 1/2 (2CW)

Junctions

Blended to improve comfort
Heavy
Medium
Light

Optic Zone Diameter

TD = OZD + 2 (2CW) + 2 (3CW)
OZD = Pupil Size + 2mm
initial: 2 mm larger than pupil size measured in dim illumination
If peripheral blur or glare greater in dim, increase OZD

Fitting Philosophy

Aperture Position
Lens centered in front of pupil
When flat K is > 45.00 D
When corneal cyl is 2.00-2.50 D, diagnostic BC 1.0 mm steeper than flat K
When aperture is > 10.5 mm
Diagnostic (small) diameter 9.0 or < when Plano to -8.00
Lid Held Position
Superior lens edge remains under upper lid
Diagnostic BC is 0.1 mm flatter than flat K
Diagnostic lens diameter is 9.5-10 mm, OZD is 1-1.8 mm < diameter
When myopia is Plano to -8.00
When pt aperture is 9-10.5 mm
When flat k is <44.75
When cornea is spherical or up to 1.5 D WTR

Main topic