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Title:	The impact of wearing hyper DK rigid gas permeable contact lens on keratoconus patients
Authors:	Mustafa Abdu Ali Mohammed (P52463)
Supervisor:	Bariah Mohd Ali, Prof Dr.
Keywords:	Keratoconus Contact lens Dissertations, Academic -- Malaysia Universiti Kebangsaan Malaysia -- Dissertations
Issue Date:	30-Apr-2014
Description:	Keratoconus (KC) is a non-inflammatory disease of the cornea characterized by localized protrusion of the cornea and irregular astigmatism that result in poor vision. Understanding its characteristics is important in the diagnosis and management of the disease. This study investigates the clinical characteristics of KC patients in Klang Valley and the impacts of wearing hyper Dk rigid gas permeable (RGP) contact lens (Dk163) for 12 months on the progression of the disease and quality of life (QOL) of the patients. In phase 1, clinical characteristics of 159 KC patients from 2 public and private clinics were determined retrospectively. The results showed that KC is more common in males than females (3:1 ratio) from Malays and Indians ethnicities and manifest in young age (early 20s). The prevalence found was 0.4%. Phase 2 involved clinical investigations that monitor changes in refraction, visual acuity (VA), contrast sensitivity (CS), corneal curvature, corneal thickness, tear stability and endothelial cell morphology after wearing hyper Dk RGP contact lens for 12 months. The results showed significantly improved visual function (VA and CS) (p<0.05) but insignificant change in refraction (p>0.05) and tear stability (p>0.05. Significantly thinner (p<0.05) and flatter cornea (p<0.001) were also observed at 12 months. However, specular microscope investigations showed no significant change in endothelial cell density (p=0.57), coefficient variation of endothelial cell size (p=0.65) and percentage of cell hexagonality (p=0.32). Contact Lens Impact on Quality of Life (CLIQ) questionnaire was administered to all subjects after 12 months of contact lens wear. The analysis indicated that QOL of all subjects was markedly improved with contact lens wear. The QOL score was not correlated with age or corneal steepening (p>0.05). This study concludes that ethnicity and gender play a role in the prevalence of KC and must be taken into consideration by eye care practitioners during vision screening. Hyper Dk RGP contact lens wear introduced 'flattening effects' on cornea that probably contribute to the delay of the disease progression, improved visual functions and QOL of KC patients. It is recommended that Optometrists fit hyper Dk RGP contact lenses as an alternative management for KC patients. However, regular follow up examination is recommended to prevent complications that may arise due to longitudinal contact lens wear.,Keratokonus (KC) adalah penyakit kornea bukan inflamatori yang dicirikan oleh protrusi lokal kornea dan astigmatisma tidak regular yang menyebabkan penurunan penglihatan. Pemahaman tentang ciri penyakit ini penting untuk tujuan diagnosis dan rawatan. Kajian ini bertujuan untuk mengkaji ciri klinikal pesakit keratokonus di Lembah Klang dan impak pemakaian kanta sentuh Dk tinggi (Dk163) selama 12 bulan keatas perkembangan penyakit dan kualiti hidup pesakit KC. Ciri klinikal 159 orang pesakit KC dari klinik mata kerajaan dan awasta dikaji secara retrospektif dalam fasa pertama kajian. Keputusan kajian menunjukkan penyakit KC lebih banyak dialami oleh lelaki berbanding perempuan (nisbah 3:1) dari bangsa Melayu dan India. Penyakit ini bermanifestasi sekitar usia 20an dan prevalensnya adalah 0.004%. Fasa kedua kajian melibatkan pemeriksaan klinikal untuk memantau perubahan refraksi, akuiti visual (VA), sensitiviti kontras (CS), kelengkungan kornea, ketebalan kornea, kestabilan air mata dan morfologi sel endotelium keatas 23 orang pesakit KC selepas pemakaian kanta sentuh RGP Dk tinggi selama 12 bulan. Keputusan kajian menunjukkan peningkatan nilai VA dan CS yang signifikan (p<0.001) tetapi tidak signifikan pada nilai refraksi (p>0.05) dan kestabilan air mata (p>0.05) selepas pemakaian kanta RGP selama 12 bulan. Keputusan kajian juga menunjukkan kelengkungan kornea menjadi lebih datar (p<0.05) dan ketebalan kornea berkurang (p<0.05) secara signifikan selepas 12 bulan. Walaubagaimana pun, kajian menggunakan mikroskop spekular mendapati tiada perubahan yang signifikan pada densiti sel endotelium (p=0.86), variasi koefisyen saiz sel endotelium (p=0.57) dan peratusan sel heksagonal (p=0.32). Survei tentang impak pemakaian kanta sentuh keatas kualiti hidup (CLIQ) telah diberikan kepada semua pesakit selepas 12 bulan memakai kanta sentuh RGP. Analisa keputusan menunjukkan kualiti hidup (QOL) pesakit KC meningkat dengan pemakaian kanta sentuh RGP dan tidak berkorelasi dengan umur atau nilai kecerunan kornea (p>0.05). Kajian ini merumuskan bahawa etnik dan jantina memainkan peranan dalam penentuan prevalens KC dan perlu diberi perhatian sewaktu menjalankan saringan penglihatan. Pemakaian kanta sentuh RGP Dk tinggi memberi kesan 'pendataran kornea' yang mungkin menyumbang kepada kawalan perkembangan KC, peningkatan fungsi visual dan kualiti hidup pesakit KC. Adalah dicadangkan supaya Optometris menggunakan kanta sentuh RGP Dk tinggi dalam pengurusan pesakit KC. Walaubagaimana pun pemeriksaan lanjutan secara berkala adalah perlu bagi mengelakkan sebarang komplikasi akibat pemakaian kanta sentuh secara berpanjangan.,Ph.D.
Pages:	174
Call Number:	WW220.M991i 2014 9 tesis
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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