Purpose: To determine the optical indications for contact lens wear after corneal transplantation. The type of lenses used, fitting philosophy, visual outcomes, and complications were examined.
Methods: A 4-year retrospective chart review was performed and identified 35 eyes in 30 patients wearing contact lenses for visual rehabilitation after penetrating keratoplasty.
Results: The optical indications for contact lens fitting after penetrating keratoplasty were multifactorial and included irregular astigmatism (62.9%), spherical anisometropia (57.1%), and astigmatic anisometropia (54.3%). The average time from surgery to initial contact lens fitting was 18.2 months. Spherical rigid gas-permeable lenses were the most common type of lens used. The mean best-corrected visual acuity improved from less than 20/40 with spectacles alone to better than 20/30 when using a contact lens. Punctal occlusion and lubrication helped to improve contact lens tolerance. Complications associated with contact lens use tended to be minor and responded generally well to conservative treatment measures.
Conclusion: Contact lenses can improve visual function in patients with irregular astigmatism and anisometropia after penetrating keratoplasty.