ICD FlexFit

ICD FlexFit*

From - £136.58

ICD FlexFit is a family of vaulting miniscleral contact lenses designed to achieve excellent results with even the most challenging eye shapes.

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When to use

For patients who suffer with:

  • Keratoconus
  • Pellucid marginal degeneration
  • Post-refractive surgery
  • Ocular surface disease
  • Corneal transplants
  • Keratoglobus
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Parameters

Sag Height / Diameter:

15.6 mm standard –
16.0 mm –
16.4 mm –

 

3800 to 6200 in 50 micron steps
3800 to 6600 in 50 micron steps
4000 to 6600 in 50 micron steps

Mid-Peripheral Value (M)+200 to -200 in 25 micron steps
Limbal Value (L)+200 to -200 in 25 micron steps
Edge (E)+250 to -250 in 25 micron steps

 

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Fitting Guide

Fitting philosophy
  • ICD flex fit uses similar tangential curve technology to the original ICD to maintain good corneal clearance however with the flex fit technology the diameter can be flexed up or down without having to re-fit the patient with a different lens.
  • The unique scribe marks allow for accurate alignment with the limbal area to assess whether the diameter needs adjusting. If the diameter is adjusted the FlexFit automatically adjusts the tangential curves to maintain the correct apical clearance.
  • Another unique feature of the FlexFit is quadrant specific edge lift to create lift over pinguecula or Glaucoma shunts.
  • The 16.3 mm diameter lens also has dual depth edges to account for scleral toricity allowing for a better more aligned fit than a continuous depth edge.
Initial fitting lens selection
  • Normal to low depth eyes, ie OSD, post refractive surgery use a 16.3 diameter 4000 micron sag
  • Median depth eyes, early to moderate Keratoconus, Pellucid Marginal Degeneration or low depth grafts then use a 16.3 with a sag of 4400 microns.
  • High depth eyes such as protruding grafts or advanced Keratoconus use a 16.3 with a sag of 4800 microns.
    Ideal clearance
    • On initial insertion aim for approximately 300 microns of clearance, the fluid layer and lens thickness should be approximately the same. The fluid layer thickness allows for settling back to occur which will reduce the clearance over time.
    • After settling back has occurred the clearance should be approximately 150 – 200 microns.
    • Use a slit lamp optic section or anterior OCT to check clearance values.
    Fitting guide
    • The lens should completely clear or vault the cornea with no touch anywhere and land on the sclera.
    • Use white light to see the demarcation of the Fluorescein layer. Increase the LCZ in 25-micron steps if the limbal clearance is insufficient. Five steps which equals 125-microns is normally the minimum adjustment.
    • If there is shown to be minimal clearance in the mid-periphery then increase the PCCZ value 5 steps would be clinically significant.
    • Remember that these changes will also increase the sag of the lens.
    • Finally assess the Scleral Landing Zone to see if there is excessive edge lift or vessel impingement.
    • Verify that the SLZ is in alignment 360 degrees around the Sclera.
    • Make adjustments based on: Mildly tight SLZ -1, Moderately tight SLZ -2, very tight SLZ -3. Every 1 degree of change alters the sag by 25 microns.

    Over-refraction

    • Perform an over-refraction preferably spherical where possible, if residual cylinder is detected the ICD FlexFit 16.3 has a 125-micron difference in elevation to allow the lens to align on the toroidal Sclera. This ALZ, asymmetric landing zone allows the lens to stabilise and prevents the lens rocking on the flat meridian. Make a note of the direction of rotational stability of the toric marks.

    Ordering

    • To order the ICD FlexFit the specification must include the Sag of the lens required, any adjustments to the PCCZ, LCZ and SLZ. The power of the lens required, if a toric is needed then the direction of the flat marks as well as the Cylinder axis is required and this may not align with the Cylindrical direction.
    • Remember the diameter can be flexed up or down in 0.1 mm steps without needing to fit the Patient with another trial lens.