Glaucoma Questions

Glaucoma-related fitting questions from fitters and replies by Paul Rose

last updated 2020.12.29

Q: Wouldn’t a truncated design be a better fit for the glaucoma shunt case? Rather than the segment specific ACT that has some bearing on the shunt.

A: Truncations occur at the bottom of the lens and cause the edge of the XL lens to be too close to the limbus so this causes bubbles to be introduced on blinking.

Q: Could Rose K XL influence the PIO? I am asking this for patient with glaucoma.

A: I assume you are meaning the IOP?  Although there has been no official study on this because the suction forces are much less with XL than normal scleral lenses then one would not expect it to affect the IOP.  To date I have had no cases reported to me of increased IOP with XL.

Q: Do XL lenses increase IOP seeing that there is bearing on the Limbal area?

A: The bearing with XL is actually inside the limbus on the cornea, not on the limbus. I have had no cases to date reported to me of increased IOP with XL.  Perhaps you could do a study?

Q: How far it is Successful or any successful cases with Glaucoma cases?

A: I assume you are referring to Rose K2 XL? If so, I have had three cases with glaucoma shunts reported to me that were successful. I have no information on patients with glaucoma (no shunt) wearing XL but because the lens lands on the cornea and has much less suction force than sclerals then I would expect them not to affect the fit.  Would be a good study.