Abstract
Purpose
To investigate the effect of rigid gas permeable (RGP) contact lenses in patients with corneal scar and opacity following repair of corneal perforations.
Methods
A total of 10 eyes from 10 patients undergoing repair of corneal perforating injuries and fitted with RGP contact lenses were examined in the present study. The mean postoperative 3-month visual acuities, refraction, corneal topography, keratometry, best corrected visual acuities with spectacles and RGP lenses at an average of postoperative 3 months were evaluated.
Results
Eight eyes had corneal opacities at the central and 2 eyes at the peripheral portion. Four patients had previous cataract surgery or cataract surgery with intraocular lens insertion due to traumatic cataract. The mean postoperative 3-month LogMAR visual acuity was 1.14 ± 0.53. Corneal topography showed irregular astigmatism in all patients and the mean keratometric astigmatism was 4.03 ± 4.06 diopters. The mean best corrected LogMAR visual acuities with spectacles was 0.91 ± 0.64 and with the RGP contact lens was 0.25 ± 0.35. A comparative analysis of improvement in visual acuity with the RGP contact lens over spectacle correction was found to be statistically significant (p = 0.005). Patients wore the lenses for more than 6 hours daily for the mean follow-up period (12.10 ± 7.80 months).
References
1. Kok JH, Visser R. Treatment of ocular surface disorders and dry eyes with high gas-permeable scleral lenses. Cornea. 1992; 11:518–22.
2. Schein OD, Rosenthal P, Ducharme C. A gas-permeable scleral contact lens for visual rehabilitation. Am J Ophthalmol. 1990; 109:318–22.
3. Hafner A, Langenbucher A, Seitz B. Long-term results of phototherapeutic keratectomy with 193-nm excimer laser for macular corneal dystrophy. Am J Ophthalmol. 2005; 140:392–6.
4. Förster W, Atzler U, Ratkay I, Busse H. Therapeutic use of the 193-nm excimer laser in corneal pathologies. Graefes Arch Clin Exp Ophthalmol. 1997; 235:296–305.
5. Lin DT, Webster RG Jr, Abbott RL. Repair of corneal lacerations and perforations. Int Ophthalmol Clin. 1988; 28:69–75.
6. Høvding G. Hydrophilic contact lenses in corneal disorders. Acta Ophthalmol. 1984; 62:566–76.
7. Smiddy WE, Hamburg TR, Kracher GP, et al. Contact lenses for visual rehabilitation after corneal laceration repair. Ophthalmology. 1989; 96:293–8.
8. Goggin M, Alpins N, Schmid LM. Management of irregular astigmatism. Curr Opin Ophthalmol. 2000; 11:260–6.
9. Betts AM, Mitchell GL, Zadnik K. Visual performance and comfort with the Rose K lens for keratoconus. Optom Vis Sci. 2002; 79:493–501.
10. Dada VK, Agarwal LP, Martin S, Harris RL. Visual acuity improvement in eyes with corneal scars fitted with contact lenses. Am J Optom Physiol Opt. 1975; 52:211–5.
11. Titiyal JS, Das A, Dada VK, et al. Visual performance of rigid gas permeable contact lenses in patients with corneal opacity. CLAO J. 2001; 27:163–5.
12. Titiyal JS, Sinha R, Sharma N, et al. Contact lens rehabilitation following repaired corneal perforations. BMC Ophthalmol. 2006; 6:11.
13. Kanpolat A, Ciftçi OU. The use of rigid gas permeable contact lenses in scarred corneas. CLAO J. 1995; 21:64–6.
14. Jupiter DG, Katz HR. Management of irregular astigmatism with rigid gas permeable contact lenses. CLAO J. 2000; 26:14–7.
15. Elliott DB, Mitchell S, Whitaker D. Factors affecting light scatter in contact lens wearers. Optom Vis Sci. 1991; 68:629–33.
16. Prasad A, Asbell PA, Senie RT. Evaluation of glare in normal and pseudophakic subjects. Ann Ophthalmol. 1991; 23:268–72.
17. Kim US, Jin KH. Clinical features of corneal erosion in contact lens wearers. J Korean Ophthalmol Soc. 2002; 43:1369–74.
Table 1.
BCVA = best corrected visual acuity; FC = finger count; E+P = extracapsular cataract extraction+posterior chamber lens insertion; ppV+ppL+IOL SF = pars plana vitrectomy+pars plana lensectomy+intraocular lens scleral fixation; K+P = phacoemulsification+ posterior chamber lens insertion; Mean keratometric astigmatism = Sim K's astigmatism of Orbscan (Orbscan, Inc, Salt Lake City, UT, USA) corneal topography.