Bitoric rigid gas permeable contact lenses in the optical management of penetrating keratoplasty

Abstract

The purpose of this study was to evaluate the complexity and effectiveness of fitting bitoric rigid gas permeable contact lenses (RGPCLs), compared to spherical RGPCLS, when used in the correction of high amounts of post-penetrating keratoplasty astigmatism. Records of post-penetrating keratoplasty (PKP) patients being managed with bitoric RGPCLs were compared to controls (post-PKP patients managed with spherical RGPCLs). Factors that were analyzed included the number of diagnostic RGPCLs used to assess the initial fit, the number of RGPCLs ordered to finalize the fit and the number of total doctor visits to finalize the fit. Fourteen eyes of 14 patients satisfied the study criteria. The average amount of total astigmatism in this study group was 10.0D±5.0 compared to the control group which was 3.3D±2.6. The number of diagnostic RGPCLs used for the study group was 1.2±0.4 compared to 1.0±0.0 for the control group. The mean number of contact lenses ordered to complete the fitting for the study group was 1.9±0.7 compared to the control which was 2.1±0.8. The study group presented for an average of 6.3±1.6 visits whereas the control group presented for 4.9±1.1 visits. Contact lens corrected acuity for the study group was 0.101±0.11 (20/25) compared to the control group 0.08±0.12 (20/24). The complexity of fitting bitoric RGPCLs was found to be similar to fitting spherical RGPCLs on post-PKP eyes and the visual outcomes were not different.