Comparación en la adaptación de lentes de contacto blandos EXACTA SK® versus lente escleral AKS® en paciente con queratocono y antecedente de cross-linking en Turbo-Antioquia 2026. Reporte de caso

Abstract

Introduction: Keratoconus is a progressive corneal ectasia that causes refractive alterations, decreased visual acuity, and deterioration in quality of life. Although corneal cross-linking helps slow disease progression, many patients require contact lenses for visual rehabilitation. However, there is limited evidence comparing the performance of scleral lenses and customized soft contact lenses, particularly in patients with a history of corneal cross-linking. Objective: To compare the fitting, visual performance, and quality of life achieved with EXACTA SK® soft contact lenses and AKS® scleral lenses in a patient with bilateral keratoconus and a history of corneal cross-linking. Methods: A descriptive observational case report was conducted in a 24-year-old female patient. An optometric examination, corneal topography, and comparative fitting of both contact lens designs were performed. Visual acuity, lens fit, tolerance, and quality of life were evaluated using the Keratoconus Outcomes Research Questionnaire (KORQ) before and after contact lens use. Results: Both lens designs improved visual acuity to 20/25 in both eyes. Scleral lenses demonstrated greater clinical stability; however, their use was limited by difficulties with insertion and removal. EXACTA SK® soft contact lenses showed good fitting, ease of handling, and adequate tolerance. The Keratoconus Outcomes Research Questionnaire (KORQ) showed a reduction in activity limitations (from 3.16 to 1.0) and visual symptoms (from 2.0 to 1.2), indicating a significant improvement in the patient’s quality of life. Conclusions: Both types of contact lenses were effective for visual rehabilitation; however, EXACTA SK® soft contact lenses provided better functional adaptation due to their ease of use. The KORQ assessment demonstrated a substantial improvement in the patient’s quality of life.