J Korean Ophthalmol Soc.  2010 Oct;51(10):1312-1318.

Vision-Correction Effect of RGP Contact Lens in Patients With Corneal Opacity Following Repaired Corneal Perforations

• Cho HK
• Choi JH
• Yang JW
• Lee YC
• Kim SY

Abstract

PURPOSE
To investigate the effect of rigid gas permeable (RGP) contact lenses in patients with corneal scar and opacity following repair of corneal perforations.
METHODS
A total of 10 eyes from 10 patients undergoing repair of corneal perforating injuries and fitted with RGP contact lenses were examined in the present study. The mean postoperative 3-month visual acuities, refraction, corneal topography, keratometry, best corrected visual acuities with spectacles and RGP lenses at an average of postoperative 3 months were evaluated.
RESULTS
Eight eyes had corneal opacities at the central and 2 eyes at the peripheral portion. Four patients had previous cataract surgery or cataract surgery with intraocular lens insertion due to traumatic cataract. The mean postoperative 3-month LogMAR visual acuity was 1.14 +/- 0.53. Corneal topography showed irregular astigmatism in all patients and the mean keratometric astigmatism was 4.03 +/- 4.06 diopters. The mean best corrected LogMAR visual acuities with spectacles was 0.91 +/- 0.64 and with the RGP contact lens was 0.25 +/- 0.35. A comparative analysis of improvement in visual acuity with the RGP contact lens over spectacle correction was found to be statistically significant (p = 0.005). Patients wore the lenses for more than 6 hours daily for the mean follow-up period (12.10 +/- 7.80 months).
CONCLUSIONS
In patients with corneal scar and opacity following repair of corneal perforations, RGP contact lens fitting should be considered first before surgical corrections such as keratoplasty.

Keyword

Corneal opacity; Corneal perforation; Corneal scar; RGP contact lens; Trauma

MeSH Terms

Astigmatism
Cataract
Cicatrix
Contact Lenses
Corneal Opacity
Corneal Perforation
Corneal Topography
Corneal Transplantation
Eye
Eyeglasses
Follow-Up Studies
Humans
Lenses, Intraocular
Visual Acuity

Figure

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  Figure 1. (A) Anterior segment photograph showing full-thickness corneal laceration with cornea touched iris in patient 3. (B) Anterior segment photograph showing central corneal opacity 2 months after the primary closure. (C) Orbscan corneal topograph showing irregular astigmatism at the center of the cornea 2 months after the primary closure. (D) Centralization of RGP lens at fitting. (E) Orbscan corneal topograph 13 months after RGP fitting. Note that corneal astigmatism has decreased from 6.2 diopters to 3.3 diopters.

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  Figure 2. (A), (B) Anterior segment photograph showing central corneal opacity 3 months after pars plana vitrectomy, lensectomy and intraocular lens scleral fixation and 4 months after the primary closure in patient 6. (C) Orbscan corneal topograph showing irregular astigmatism at the center of the cornea 4 months after the primary closure. (D) Centralization of RGP lens at fitting. (E) Orbscan corneal topograph of 15 months after RGP fitting. Note that corneal astigmatism has decreased from 13.2 diopters to 8.3 diopters.

Reference

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