Use of Scleral Lenses and Miniscleral Lenses After Penetrating Keratoplasty

Eye Contact Lens. 2016 May;42(3):185-9. doi: 10.1097/ICL.0000000000000163.


Purpose: To examine the clinical outcomes of scleral lenses for visual rehabilitation after penetrating keratoplasty (PK).

Methods: A retrospective review was conducted for 34 patients (48 eyes) who had a history of prior PK and were fit with scleral lenses between October 2009 and December 2013 at the UC Davis Eye Center.

Results: The most common initial indication for PK was keratoconus in 27 eyes (56%). Thirty-three eyes (69%) had previously been fit with other types of contact lenses, with small-diameter rigid gas-permeable lenses being the most common. The improvement in best-corrected visual acuity with a scleral lens compared with prior spectacle refraction or other contact lens was a mean of two best-corrected visual acuity lines. Forty-four eyes (91.7%) achieved functional vision with best scleral lens-corrected visual acuities of 20/40 or better. Patients who continued wearing scleral lenses were significantly more likely to report "good" subjective vision compared with patients who abandoned scleral lens wear (P=0.009), although change in objective best-corrected visual acuity did not differ significantly. There were no cases of infectious keratitis. Six eyes (12.5%) developed graft rejection; 3 were able to resume scleral lens wear. Nineteen eyes (39.5%) discontinued scleral lens wear for various reasons, the most common reason for discontinuation of lens wear was difficulty with scleral lens insertion or removal (8 eyes, 42.1%).

Conclusion: Scleral lenses are effective and safe in patients who have had PK. There was a mean gain in visual acuity, with the majority of patients achieving 20/40 vision or better. The patient's subjective perception of vision was a significant factor in determining whether scleral lens wear was continued or abandoned.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contact Lenses*
  • Corneal Diseases / surgery*
  • Female
  • Humans
  • Keratoplasty, Penetrating*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prosthesis Fitting
  • Retrospective Studies
  • Sclera*
  • Vision Disorders / physiopathology
  • Vision Disorders / rehabilitation*
  • Visual Acuity / physiology