Reverse geometry contact lens fitting in corneal scar caused by perforating corneal injuries.
OBJECTIVE
To describe a reverse geometry rigid gas permeable (RGP) contact lens fitting in corneal scar caused by perforating corneal injuries with intraocular strange body.


METHODS
A reverse geometry RGP lens, with large diameter, was empirically fitted in a 38-year-old male patient who had previous open globe injuries due to work accident in right eye. Corneal suture, vitrectomy and lens extraction were performed. Irregular corneal surface with corneal scar in line with the visual axis were found with low uncorrected visual acuity.


RESULTS
Snellen visual acuity improved from counterfinger to 0.8 with high contact lens acceptance, 6-9h per day of wear. Only three diagnostic contact lenses, in two visits, were necessary. Orbscan simulated fluorescein pattern was different to definitive fluorescein pattern.


CONCLUSIONS
Reverse geometry RGP contact lens, with large diameters, could be a good alternative in irregular corneal surface with corneal scar. Fluorescein pattern analysis could be the proper fitting technique. This fitting could involve less time and fewer visits. Computer-aided fitting was of limited value in these cases.
Martin
Raul
R
IOBA-Eye Institute and School of Optometry, Department of Physics TAO, University of Valladolid, Valladolid, Spain. raul@ioba.med.uva.es
de Juan
Victoria
V
D000062:Accidents, Occupational; D000328:Adult; D002921:Cicatrix / Q000473:pathology / Q000534:rehabilitation*; D003261:Contact Lenses; D003315:Cornea / Q000473:pathology*; D065306:Corneal Injuries; D019781:Corneal Topography; D004867:Equipment Design; D015807:Eye Injuries, Penetrating / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017755:Prosthesis Fitting; D012029:Refraction, Ocular; D014792:Visual Acuity