Abstract
Purpose :
Recently, surgical indications and procedures for keratoplasty (KP) have diversified and the use of postoperative contact lenses (CLs) has changed as well. New CL types have been reported as effective for patients with difficulty wearing conventional spherical lenses. This retrospective study aimed to investigate CL use after KP.
Methods :
The clinical records of patients who underwent KP and used CL postoperatively between January 2017 and December 2019 at Osaka University Hospital were reviewed. The following information was collected in each case: preoperative underlying diseases, type of KP, CL use before KP, postoperative corrected distance visual acuity (CDVA) with spectacles and CLs at the last visit, and CL type. We used Wilcoxon signed-rank sum test for statistical analysis.
Results :
Thirty-three eyes of 31 cases were included in this study. Preoperative underlying diseases were re-KP (11 eyes, 33%), keratoconus (9 eyes, 27%), leucoma (5 eyes, 15%), corneal dermoid (3 eyes, 9%), perforation (2 eyes, 6%), bullous keratopathy (2 eyes, 6%), and pellucid marginal degeneration (1 eye, 3%). The types of KP included penetration keratoplasty (PKP) (15 eyes, 45%), deep anterior lamellar keratoplasty (5 eyes, 15%), anterior lamellar keratoplasty (ALK) (6 eyes, 18%), and Descemet stripping automated endothelial keratoplasty (6 eyes, 18%). Eight eyes had previous history of CL use. Postoperatively, rigid corneal lens (RCL) was prescribed in 20 eyes (60.6%) and as trial only without prescription in 9 eyes (27.3%), piggyback prescription in 1 eye, and soft CL in 3 eyes. Of the 20 eyes for which RCL was prescribed, 12 eyes had continued RCL use. The remaining eight eyes did not use RCL. In the 12 eyes (36.3%) under continuous RCL, RCL provided significantly better logMAR CDVA (0.23) than spectacles (0.54) (P<0.01). Eleven patients continuously used multi-curved RCL, and one used spherical RCL. Re-KP and keratoconus were the main etiologies; all corneal dermoid cases continued RCL. PKP (5 eyes, 41.7%) and ALK (5 eyes, 41.7%) were the most common techniques used in 12 eyes with continuous RCL use. The reasons for RCL discontinuation in eight eyes were difficulty handling the lenses, rejection, increased pain, and graft infection in the affected or fellow eye.
Conclusions :
Among all postoperative KP eyes, 36.3% continued to use RCL. Further, wearing RCL provided better CDVA than spectacles.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.