EC Ophthalmology

Purpose: To determine the clinical outcomes of corneo-scleral lenses with diameter of 14.50 mm to improve vision in patients after penetrating keratoplasty (PK) for visual rehabilitation.

Case Presentation: Two young patients who had undergone penetrating or lamellar keratoplasty before one year were treated with Scleral contact lens and were observed for improvement in best corrected visual acuity after treatment with 14.50 mm Mc-Asfeer corneo-Scleral lens.

Result: A maximum keratometry value of patient A and B were 52.50 D and 58.25 D at their first visit to our clinic. Both patients were successfully fit with Mc-Asfeer corneo-Scleral lens, showing adequate central corneal clearance of about 260 μm (Patient A) and 310 μm (Patient B) with no corneal touch on AS-OCT and sufficient limbal clearance of about 120 μm with good edge clearance. After the lens insertion, BCVA improved to 6/6. The patient reported an immediate improvement in visual quality and a reduction in ghosting. Subjective comfort was also noted, with no significant discomfort.

Conclusion: This case report illustrates the successful fitting of a Corneo-Scleral contact lens in a patient following keratoplasty. Corneo-Scleral lenses should be considered as a valuable option for visual rehabilitation in post-keratoplasty patients with irregular corneal surfaces.

 Keywords: Keratoplasty; High Astigmatism; Scleral Contact Lens

1. Alipour F., et al. “Mini-scleral lenses in the visual rehabilitation of patients after penetrating keratoplasty and deep lamellar anterior keratoplasty”. Contact Lens and Anterior Eye1 (2015): 54-58.
2. Barnett M., et al. “Use of scleral lenses and mini scleral lenses after penetrating keratoplasty”. Eye and Contact Lens3 (2016): 185-189.
3. Koppen C., et al. “Scleral lenses reduce the need for corneal transplants in severe keratoconus”. American Journal of Ophthalmology 185 (2018): 43-47.
4. Kim H., et al. “Mini-scleral contact lens for Asian eyes post-penetrating keratoplasty with smaller palpebral aperture”. Clinical Optometry 13 (2021): 161-166.
5. Penbe A., et al. “Efficiency and safety of scleral lenses in rehabilitation of refractive errors and high order aberrations after penetrating keratoplasty”. Eye and Contact Lens 5 (2021): 301-307.
6. Romero-Jiménez M., et al. “Keratoconus: a review”. Contact Lens and Anterior Eye 4 (2010): 157-166.