Effects of Corneal Scars and Their Treatment With Rigid Contact Lenses on Quality of Vision.
OBJECTIVE
To study the effects of corneal scars and the treatment of these scars with rigid gas-permeable (RGP) contact lenses on quality of vision including straylight. Visual effects were related to scar characteristics such as size and grade.


METHODS
Straylight and best-corrected visual acuity were measured in 23 patients with corneal scars during and after RGP contact lens wear. Contralateral eyes were used as controls, and age-normal values in case of bilateral scars. Straylight measurements were performed using the compensation comparison method of the Oculus C-Quant instrument.


RESULTS
Scarred eye straylight values were 1.53 log(s) without contact lens and 1.60 log(s) with contact lens (P=0.043). Healthy eyes without contact lens had a mean straylight value of 1.13 log(s), corresponding to age-normal values. Contact lens wear increased straylight in healthy eyes to 1.26 log(s) (P<0.001). Visual acuity improved from 0.66 logarithm of minimal angle of resolution (logMAR) to 0.19 logMAR with contact lens wear in eyes with a corneal scar (P<0.001).


CONCLUSIONS
Corneal scars can have a strong effect on quality of vision by diminishing visual acuity and increasing straylight. The increase in straylight from corneal scars on its own can lead to a serious visual handicap. Contact lens treatment did not improve straylight, but showed a slight worsening. As the recovery of visual acuity with contact lens wear far exceeded straylight increase, contact lenses remain a clinically useful treatment option in most patients with corneal scars.
University of Amsterdam (B.d.J.), Faculty of Medicine, Amsterdam, the Netherlands; Department of Ophthalmology, Academic Medical Center (I.J.E.v.d.M., J.M.J.v.V., R.L.-G., C.P.N.), Amsterdam, the Netherlands; Retina Total Eye Care (I.J.E.v.d.M., R.L.-G.), Driebergen, the Netherlands; Netherlands Institute for Neuroscience (T.J.T.P.v.d.B.), Netherlands Royal Academy, Amsterdam, the Netherlands; and Oculenti Contact Lenses (J.M.J.v.V.), Zoetermeer, the Netherlands.
Bram
B
de Jong
Ivanka J E
IJE
van der Meulen
Johannes M J
JMJ
van Vliet
Ruth
R
Lapid-Gortzak
Carla P
CP
Nieuwendaal
Thomas J T P
TJTP
van den Berg
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003261:Contact Lenses; D003315:Cornea / Q000473:pathology*; D065306:Corneal Injuries / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015599:Trauma Severity Indices; D014792:Visual Acuity; D055815:Young Adult