Contact Lens Fitting Following Corneal Graft Surgery

Abstract

Keratoplasty is one of the best options for the visual rehabilitation of patients with history of corneal pathologies. However, the method is still associated with poor postoperative visual acuity (VA) due to high levels of astigmatism, corneal irregularity, and anisometropia. The prescription of contact lenses (CLs) for patients submitted to corneal transplantation can be challenging but also highly rewarding. The incidence of CL use following corneal transplantation varies greatly (16–96%). The study by Anette J N et al. found that 47% of the keratoplasty patients used CLs and only 5% of patients stopped using it. There are several CL options available on the market that can be used for this purpose. Hydrogel CL, Hybrid CL, and rigid gas-permeable CL (corneal, semi-scleral, mini-scleral, and scleral) are examples. The last one is the most used for post-graft patients due to its characteristics of oxygen permeability and correction of irregular astigmatism. Another type of CL that can be used is Bandage CL. This type of lens has been used to aid epithelialization, manage small punctures, relieve irritation caused by sutures, and smoothen marginal corneal irregularities. This chapter aims to discuss CL fitting following corneal graft surgery approaching different scenarios and types of CLs.