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G.T. Smith, T. Poole, K.W. Pullum, L.A. Ficker; Scleral Lenses for Visual Rehabilitation Following Corneal Transplant . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3681.
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Purpose: Post corneal transplant astigmatism can be mostly neutralized by the pre-corneal fluid reservoir entrapped behind rigid gas permeable (RGP) contact lenses, but irregularities at the host / donor junction may cause corneal diameter lenses to be too unstable. A scleral contact lens (ScCL) does not depend on close alignment to the cornea because it bears on the sclera, so may circumvent this problem. This presentation is intended to evaluate visual rehabilitation with scleral contact lenses. Methods: The notes of 28 corneal transplant patients fitted with ScCLs and followed up for at least 12 months at Moorfields Eye Hospital were retrospectively reviewed. Secondary interventions, post operative complications and rejection episodes were also recorded. Results: There were 28 patients (37 eyes), 19 using a ScCL in one eye and 9 in both eyes. The age range of the patients at the time of lens fitting was 18 to 80 years. The median follow up after lens fitting was 4 years (range: 1.3 – 47.2). Snellen visual acuity was 6/9 or better for 26 (93%) patients. Four patients experienced one or more transplant rejection episodes prior to ScCL fitting. There were only three rejection episodes, two of which occurred in the same patient prior to the availability of RGP ScCLs. There were no significant or sight-threatening complications directly attributable to ScCL wear. Conclusions: ScCLs proved useful for the visual rehabilitation following corneal transplant where other contact lens strategies had failed. The lenses were well tolerated and were associated with few complications.
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