Adaptación de lente de contacto rígido de apoyo escleral en paciente pediátrico con diagnóstico de queratocono avanzado. Reporte de caso.

Abstract

Keratoconus (KC) is defined as a corneal ectasia caused by progressive corneal curvature accompanied by thinning of the apical stroma (1), which can present as unilateral or bilateral, depending on the case. It typically manifests in the second decade of life and stabilizes in the fourth decade (2). As corneal deterioration progresses, conventional refractive methods become ineffective, making the use of Scleral Lenses (SL) significant. Objective: To determine the ideal adaptation for visual rehabilitation with scleral lenses in a pediatric patient diagnosed with advanced keratoconus. Methodology: Descriptive observational study, case report of a pediatric patient with a diagnosis of advanced keratoconus. Case presentation: A 16-year-old female patient, resident of Bogotá, diagnosed with advanced keratoconus in both eyes for 2 years. Clinical management: Ophthalmological evaluations with future surgical treatment options, including Keratoplasty (KP). Contact lens fitting and adjustments with Rigid Gas Permeable lenses (RGP) by optometry without adherence to treatment for 2 years. Results: SL (Custom Stable Elite) were fitted, achieving visual comfort for 8 to 10 hours daily and good visual acuity for both distance and near (20/30 in both eyes). Conclusion: Scleral lenses provide new alternatives compared to RGP contact lenses in irregular corneas, offering greater comfort and maximizing visual function in the pediatric population, ultimately delaying the need for QP.