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Anja Katharina Gruenert, Juergen Hausser, Gerd Geerling, Thomas Armin Fuchsluger; Special back surface designed contact lenses to correct irregular astigmatism in patients after penetrating keratoplasty. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4674.
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To analyze the use of advanced contact lenses with a special asymmetric back surface design in patients with complex topographic conditions following penetrating keratoplasty (pKP).
81 eyes with asymmetric corneal topographies after pKP were fitted with rigid gas permeable contact lenses characterized by a special asymmetric back surface design. Fitting of regular rigid contact lenses had been unsuccessful in all of these eyes. Four different lens types (Quadro, QS, DEC, Asym) were used. The contact lens-corrected visual acuity (VA) was determined and compared to the best spectacle-corrected VA. Lens tolerance and patient satisfaction were evaluated.
Mean age at the time of contact lens fitting was 54.8 years (SD ±14.8 years). The most frequent condition leading to penetrating keratoplasty was keratoconus (48.6%), followed by Fuchs dystrophy/endothelial damages (31.1%), stromal corneal dystrophies (10.8%) and other corneal diseases (9.5%). Mean contact lens-corrected VA was significantly better than mean spectacle-corrected VA (0.76 versus 0.4). Best results were achieved with QS-contact lenses (VA: 0.82 versus 0.34). In 96.3% of the eyes contact lenses with a special back surface design improved VA. In the other cases VA did not differ with contact lens- or spectacle-correction, but the use of contact lenses was required to prevent aniseikonia. Lens tolerance was moderate and some patients did not continue contact lens wear due to discomfort, handling problems or other reasons.
Contact lenses with a special asymmetric back surface design can correct irregular astigmatism after penetrating keratoplasty and lead to a better functional outcome. Moreover, they are an effective tool to prevent aniseikonia in patients with high spheric or toric anisometropia.
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