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Contact lenses and special back surface design after penetrating keratoplasty to improve contact lens fit and visual outcome

¹ Department of Ophthalmology, Martin-Luther University, Halle, Germany
² Institute of Optometry, Trothe-Optik, Halle, Germany

Correspondence to:
Correspondence to:
Dr Claudia Gruenauer-Kloevekorn
Department of Ophthalmology, Martin-Luther University, Ernst-Grube-Strasse 40, 06097 Halle, Germany; claudia.gruenauer-kloevekorn{at}medizin.uni-halle.de

Aims: To describe the fitting of patients with high or irregular astigmatism following penetrating keratoplasty with contact lenses and to answer the question whether or not contact lenses with special back surface design can improve visual acuity in complex cases after penetrating keratoplasty.

Methods: 28 eyes were included. They were fitted with contact lenses with a special back surface that was designed for optical rehabilitation after penetrating keratoplasty. Four different types of these lenses (tricurve, keratoconus, reverse, oblong) were used selectively depending on abnormal eccentricity determined by videokeratoscope. The patients were followed up for an average period of 15.5 months. Lens tolerance and corrected visual acuity were evaluated and compared with that corrected with spectacles.

Results: The visual acuity was significantly improved in nearly all eyes with an average increase of 3.6 lines (maximal nine lines) accompanied by good contact lens tolerance and satisfactory contact lens fit. No noticeable complications were observed.

Conclusion: Contact lenses with special back surface design can improve visual results and lens tolerance, and minimise problems in contact lens fitting. This is in favour of contact lenses as an alternative to surgical procedures for correction of high or irregular astigmatism after penetrating keratoplasty. This procedure is recommended especially in cases of patients who decline further operative interventions.

Abbreviations: BCVA, best corrected visual acuity; HOA, higher order aberrations; RGP, rigid gas permeable; RMS, root mean square; TD, topographic disparity

Keywords: special rigid gas permeable contact lenses; keratoplasty; astigmatism; eccentricity