Why do patients with improved visual acuity drop out of RGP contact lens use? Ten-year follow-up results in patients with scarred corneas.
OBJECTIVE
To evaluate the long-term results of rigid gas permeable (RGP) contact lenses and to investigate the reasons for patient dissatisfaction with this therapy.


METHODS
Records of 17 patients (20 eyes) who started using RGP contact lenses for correction of irregular astigmatism due to scarred corneas between 1995 and 1996 were evaluated retrospectively. Best-corrected visual acuities with or without RGP contact lenses were noted. The mean duration of contact lens use, reasons for discontinuation of therapy, and treatment methods preferred over contact lens use were evaluated.


RESULTS
The irregular astigmatisms were induced by herpetic keratitis (3 eyes), corneal trauma (5 eyes), and previous corneal infections (12 eyes). All of the patients had increase in visual acuity with RGP contact lenses (p=0.000). At the end of the follow-up it was found that only one patient was still using RGP contact lenses (5%). The mean duration for contact lens use was 21.42+/-4.53 SE months (2-72 months). The reasons for dropping out contact lenses were intervening surgical procedures (57.8%), loss of patient motivation (26.3%), recurrent punctate epitheliopathy (10.5%), and herpes simplex keratitis reactivation (5.2%).


CONCLUSIONS
RGP contact lens use is a successful method of increasing visual acuity in scarred corneas. However, patients with good visual acuity in the fellow eye find it hard to remain motivated for RGP contact lens use in the unhealthy eye. Furthermore, patients prefer permanent treatment methods even though these methods would result in decreased visual acuity.
Ozkan
Berna
B
Ophthalmology Department, Faculty of Medicine, Kocaeli University, Kocaeli - Turkey. aydoganberna@yahoo.com
Elibol
Orhan
O
Yuksel
Nursen
N
Altintas
Ozgul
O
Karabas
Levent
L
Caglar
Yusuf
Y
D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000628:therapy; D002648:Child; D003261:Contact Lenses / Q000706:statistics & numerical data*; D003316:Corneal Diseases / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult