Topographic stability and safety of contact lens use after penetrating keratoplasty.
OBJECTIVE
We evaluated long-term corneal topographic stability and the safety of contact lens use after penetrating keratoplasty (PK).


METHODS
Over a period of 3 years, we followed 18 patients who had been fit with rigid gas permeable (RGP) contact lenses after PK on the basis of computerized topographic measurements 1.5 mm superior to the visual axis. Computerized corneal topography, keratometry, refraction, visual acuity, slit-lamp examination, and contact lens parameters were recorded at the time of lens fitting and at 3 years follow-up. Comparison between the two times was performed using the paired Student's t test. The ten patients (55.5%) that did not undergo suture removal after initial contact lens fitting and who did not change contact lens type during the follow-up period were considered eligible for topographic and keratometric evaluation.


RESULTS
Absolute keratometric astigmatism, average keratometric values, computerized corneal topography measurements 1.5 mm superior to the visual axis, and inferior minus superior measurements did not reveal significant differences over time. Keratometric vector analysis showed a significant change in astigmatism during the study period. Complications observed in the 18 patients included suture infiltrates (two patients), corneal neovascularization (six patients), graft rejection (five patients), transitory punctate epithelial keratitis (eight patients), and giant papillary conjunctivitis (three patients). All were successfully treated topically and with temporary cessation of contact lens wear.


CONCLUSIONS
RGP contact lens use after PK is safe provided patients are properly fit and followed by the ophthalmologist. Although corneal topographic changes occur, stability remains acceptable.
Gomes
J A
JA
Cornea Service, Wills Eye Hospital, Philadelphia, PA 19107, USA.
Rapuano
C J
CJ
Cohen
E J
EJ
D000328:Adult; D000368:Aged; D003261:Contact Lenses / Q000009:adverse effects*; D003315:Cornea / Q000473:pathology*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012189:Retrospective Studies