title: Contact lenses and special back surface design after penetrating keratoplasty to improve contact lens fit and visual outcome.
abstract: OBJECTIVE
  To describe the fitting of patients with high or irregular astigmatism following penetrating keratoplasty with contact lenses and to answer the question whether or not contact lenses with special back surface design can improve visual acuity in complex cases after penetrating keratoplasty.
  
  
  METHODS
  28 eyes were included. They were fitted with contact lenses with a special back surface that was designed for optical rehabilitation after penetrating keratoplasty. Four different types of these lenses (tricurve, keratoconus, reverse, oblong) were used selectively depending on abnormal eccentricity determined by videokeratoscope. The patients were followed up for an average period of 15.5 months. Lens tolerance and corrected visual acuity were evaluated and compared with that corrected with spectacles.
  
  
  RESULTS
  The visual acuity was significantly improved in nearly all eyes with an average increase of 3.6 lines (maximal nine lines) accompanied by good contact lens tolerance and satisfactory contact lens fit. No noticeable complications were observed.
  
  
  CONCLUSIONS
  Contact lenses with special back surface design can improve visual results and lens tolerance, and minimise problems in contact lens fitting. This is in favour of contact lenses as an alternative to surgical procedures for correction of high or irregular astigmatism after penetrating keratoplasty. This procedure is recommended especially in cases of patients who decline further operative interventions.
authors.affiliation: Department of Ophthalmology, Martin-Luther University, Ernst-Grube-Strasse 40, 06097 Halle, Germany. claudia.gruenauer-kloevekorn@medizin.uni-halle.de
authors.forename: C
authors.initials: C
authors.lastname: Gruenauer-Kloevekorn
authors.forename: U
authors.initials: U
authors.lastname: Kloevekorn-Fischer
authors.forename: G I W
authors.initials: GI
authors.lastname: Duncker
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000209:etiology / Q000534:rehabilitation*; D003261:Contact Lenses; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery; D019781:Corneal Topography; D005139:Eyeglasses; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity