Abstract
Purpose :
Keratoplasty procedures are complex and proper post-operative management requires eyecare providers (ECPs) to optimize each patient’s best-corrected visual acuity and minimize risk of graft rejection. To better serve these patients, analysis of post-operative preferences and lens fitting by ECPs should be completed.
Methods :
A retrospective chart review of patients seen between 2011 and 2022 who had reported keratoplasty (deep anterior lamellar keratoplasty (DALK) or penetrating keratoplasty (PKP)) was performed. All patients were seen at the Illinois Eye Institute (IEI) in Chicago, Illinois, an urban academic optometry clinic. After adequate healing, the post-operative management included best visual acuity, analysis of post-operative contact lens type (GP, piggyback, scleral, etc.), contact lens solutions, and any problems documented with contact lens wear.
Results :
The IEI provides eye care to an average of 50,000-60,000 patients annually. Over the ten-year study period, the clinic examined 49 patients with keratoplasty, who had 69 total corneal transplants (surgeries performed between 1989-2022). The average age at time of study was 51 ±13.3 (range 24-76) with 59.2% of transplant recipients being male. The most common post-keratoplasty procedure observed was PKP (95.7%). The most prevalent indication for keratoplasty was corneal ectasia/keratoconus (97.1%). Post-operatively, the most fit contact lenses were scleral (47.8%) followed by corneal (17.4%), specialty soft (2.9%), and soft toric (2.9%) lenses. The remaining 20% were unaccounted for or patients who opted for no contact lenses. Reported problems with contact lens wear included: the sensation of tightness/looseness (mechanical problems noted in 24.5 % fitted), irritation, or dryness of the eyes. The average daily contact lens wear time was 10.5 ± 3.5 hours per day (n=46).
Conclusions :
Analysis of post-keratoplasty patients (commonly indicated for keratoconus at the IEI) revealed that many patients successfully reached their best-corrected visual acuity with scleral or corneal lenses. The most common contact lens problems were mechanical; however, most patients successfully wore their lenses for extended periods. These results should encourage ECPs to consider scleral or corneal lenses to maximize patient’s acuity in future cases and in the fellow eye if awaiting transplant.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.