Abstract
To report the visual rehabilitation outcomes and complications of patients fitted with mini-scleral rigid gas-permeable (RGP) contact lenses (mini-SCLs) after penetrating keratoplasty. We retrospectively reviewed 27 eyes (21 patients) that were fitted with mini-SCLs between October 2013 and December 2014. We analyzed demographic data, previous corneal disorders, visual outcomes, interval from keratoplasty to contact lens fitting, topographic and specular microscope data, fitted contact lens parameters, and complications. The patients were divided into two groups according to the elapsed time since surgery: Group A, grafts with <10 years (n=14 eyes); and Group B, grafts with ≥10 years (n=13 eyes). Lens use was discontinued in four eyes, and microbial keratitis developed in one eye during follow-up. No corneal graft rejection was observed. The mean interval between grafting and initial contact lens fitting was 10.6 ± 7.3 years (range: 1-29 years). The most frequent reason for keratoplasty was keratoconus (22 eyes, 81.4%). The mean contact lens-corrected visual acuity (CLCVA) was 0.09 ± 0.12 logMar (range: 0.50-0.00 logMar). The average topographic astigmatism, mean steepest keratometry (Kmax), and average cellularity on specular microscopy were 6.19 ± 3.49 diopters (D), 58.4 ± 7.8 D, and 1,231 ± 723 cells/mm2, respectively. Mini-SCL use allowed successful visual rehabilitation after corneal keratoplasty, particularly in patients who required corrective lenses for low visual acuity and were unable to wear RGP contact lenses. Our results indicate that mini-scleral lenses may be an option for the treatment of corneal irregularities, such as those associated with keratoplasty.
Highlights
Keratoplasty remains one of the best options, and in some cases, it is the only available option for visual rehabilitation in patients with various corneal pathologies
The retrospective data evaluation conducted in the present study included all patients with a history of penetrating keratoplasty who were fitted with ESCLERATM contact lenses (Mediphacos, Buritis, MG, Brazil) at the Cornea and Contact Lenses Department of Hospital Oftalmológico de Brasília (HOB; Brasilia, DF, Brazil) between October 2013 and December 2014
Many patients that have undergone penetrating keratoplasty depend on spectacles or contact lenses to achieve the desired visual rehabilitation
Summary
Keratoplasty remains one of the best options, and in some cases, it is the only available option for visual rehabilitation in patients with various corneal pathologies. This procedure remains associated with poor postoperative visual outcomes, such as postoperative astigmatism, irregularity, and anisometropia[1,2,3]. Some surgical and nonsurgical procedures are available to manage unsatisfactory results and to achieve visual improvement as well as binocularity. Nonsurgical strategies include spectacles and contact lenses-as spectacles tend to offer insufficient correction of strong or irregular astigmatism, as well as anisometropia, contact lenses remain a better option for visual improvement and achievement of binocularity.
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