Incidence of rigid gas-permeable contact lens wear after keratoplasty for keratoconus.
OBJECTIVE
To review retrospectively the charts of all 190 patients who underwent penetrating keratoplasty for keratoconus in one hospital during a 5-year period (1995-2000), with special attention paid to contact lens fitting.


METHODS
The frequency of postoperative contact lens use, the time to fit lenses after grafting, tolerance and visual acuity, and postoperative risks for the graft were studied.


RESULTS
The authors successfully fitted large-diameter (12 mm) tricurve rigid gas-permeable contact lenses for 90 (47%) of 190 penetrating keratoplasty patients with good tolerance. There were nine dropouts, and 91 eyes were corrected in another way. Fitting contact lenses after grafting usually started after 8.5 months (range, 1-60 months). The average tolerance was 9.2 hours a day (range, 2-12 hours), and best-corrected visual acuity was 20/25 (range, 20/16-20/200). The average follow-up was at least half a year. The average age of the patient at the first lens fitting was 36.2 years (range, 14-75 years). There was no increased risk in graft rejection.


CONCLUSIONS
Twelve-millimeter rigid gas-permeable contact lens wear was successful in 47% of patients who underwent penetrating keratoplasty for keratoconus. It does not interfere with the use of chronic postoperative topical medication, nor does it increase the risk of corneal graft rejection. It is necessary to recommend likely use of contact lenses to patients who have undergone grafting surgery.
Geerards
Annette J M
AJ
Cornea and Contact Lens Department, The Rotterdam Eye Hospital, Rotterdam, The Netherlands. drgeerards@oogziekenhuis.nl
Vreugdenhil
Willem
W
Khazen
Arash
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003261:Contact Lenses / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000534:rehabilitation* / Q000601:surgery; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity