International Journal of Keratoconus and Ectatic Corneal Diseases

Register      Login

VOLUME 2 , ISSUE 2 ( May-August, 2013 ) > List of Articles

RESEARCH ARTICLE

Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty

Rafael J Pérez-Cambrodí, Pedro Ruiz-Fortes

Citation Information : Pérez-Cambrodí RJ, Ruiz-Fortes P. Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty. Int J Kerat Ect Cor Dis 2013; 2 (2):69-72.

DOI: 10.5005/jp-journals-10025-1054

Published Online: 01-04-2016

Copyright Statement:  Copyright © 2013; The Author(s).


Abstract

Purpose

To report the successful outcome obtained after fitting a new hybrid contact lens in a cornea with an area of donor-host misalignment and significant levels of irregular astigmatism after penetrating keratoplasty (PKP).

Materials and methods

A 41-year-old female with bilateral asymmetric keratoconus underwent PKP in her left eye due to the advanced status of the disease. One year after surgery, the patient referred a poor visual acuity and quality in this eye. The fitting of different types of rigid gas permeable contact lenses was performed, but with an unsuccessful outcome due to contact lens stability problems and uncomfortable wear. Scheimpflug imaging evaluation revealed that a donor-host misalignment was present at the nasal area. Contact lens fitting with a reverse geometry hybrid contact lens (Clearkone, SynergEyes Carlsbad) was then fitted. Visual, refractive, and ocular aberrometric outcomes were evaluated during a 1-year period after the fitting.

Results

Uncorrected distance visual acuity improved from a prefitting value of 20/200 to a best corrected postfitting value of 20/20. Prefitting manifest refraction was +5.00 sphere and .5.50 cylinder at 75°, with a corrected distance visual acuity of 20/30. Higher order root mean square (RMS) for a 5 mm pupil changed from a prefitting value of 6.83 μm to a postfitting value of 1.57 μm (5 mm pupil). The contact lens wearing was referred as comfortable, with no anterior segment alterations.

Conclusion

The SynergEyes Clearkone contact lens seems to be another potentially useful option for the visual rehabilitation after PKP, especially in cases of donor-host misalignment.

How to cite this article

Pérez-Cambrodí RJ, Ruiz-Fortes P, Llorens DPP. Reverse Geometry Hybrid Contact Lens Fitting in a Case of Donor-Host Misalignment after Keratoplasty. Int J Kerat Ect Cor Dis 2013;2(2):69-72.


PDF Share
  1. Corneal transplantation. Curr Opin Ophthalmol 1992;3:473-481.
  2. Keratoconus. Surv Ophthalmol 1998;42: 297-319.
  3. Refracting the corneal graft. Surv Ophthalmol 1990;34:436-440.
  4. Contact lenses following keratoplasty. CLAO J 1991;17: 27-29.
  5. Contact lens visual rehabilitation in keratoconus and corneal keratoplasty. J Ophthalmol 2012;832070.
  6. Complexity of contact lens fitting following penetrating keratoplasty. Int Contact Lens Clin 1999;26:163-167.
  7. Fitting contact lenses for visual rehabilitation after penetrating keratoplasty. Eye Contact Lens 2004;30:31-33.
  8. Contact lens fitting following corneal graft surgery. Clin Exp Optom 2003;86:244-249.
  9. Contact lenses and special back surface design after penetrating keratoplasty to improve contact lens fit and visual outcome. Br J Ophthalmol 2005;89:1601-1608.
  10. A new technique for rigid gas permeable contact lens fitting following penetrating keratoplasty. Acta Ophthalmol Scand 2001;79:245-250.
  11. Topographic stability and safety of contact lens use after penetrating keratoplasty. CLAO J 1996;22:64-69.
  12. Fitting gaspermeable contact lenses after penetrating keratoplasty. Am J Ophthalmol 1985;99:511-514.
  13. Fitting the postkeratoplasty cornea with hydrogel lenses. CLAO J 2009;32: 22-26.
  14. Management options for the flat corneal graft. Cont Lens Anterior Eye 2004; 27:27-31.
  15. RK4 (reversegeometry) contact lens fitting after penetrating keratoplasty. Eye Contact Lens 2003;29:44-47.
  16. Fitting the SoftPerm contact lens after keratoplasty. CLAO J 1992;18:170-172.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.