High-Dk piggyback contact lenses over Intacs for keratoconus: A case report

Objective. The authors describe a case of a keratoconic patient with Intacs fitted with a high-Dk piggyback contact lens system. Methods. A 41-year-old man presented to the clinic 1 week after Intacs surgery for keratoconus with complaints of poor visual acuity (VA) and monocular polyopia OU. The patient was corrected to 20/30 in both eyes with rigid gas permeable contact lenses but could not tolerate the lenses for more than 8 hours OD and 2 hours OS. The patient was then successfully fit with a high-Dk piggyback contact lens system. Results. The patient was able to wear the piggyback contact lenses comfortably 12 to 18 hours per day and was corrected to 20/25 OD, 20/30 OS, and 20/20 OU. Conclusions. Patients with Intacs for keratoconus may require a combination of soft and rigid contact lenses for the best possible VA. Contact lens fitting with a high-Dk piggyback contact lens system can provide optimal comfort, corneal health, and VA for patients with Intacs for keratoconus.