Contact lenses for visual rehabilitation in post-keratoplasty eyes: A systematic review

To evaluate the role of contact lenses (CLs) in visual rehabilitation following keratoplasty.

Four databases, including PubMed, Scopus, Web of Science, and Embase were systematically searched for studies published between January 2010 and July 2023. Visual outcomes, daily wearing duration, subjective comfort, rate and etiology of CL discontinuation, corneal endothelial cell density, central corneal thickness, and complications were extracted.

This review included thirteen case series and two chart reviews, analyzing a total of 464 eyes, of which 97% underwent penetrating keratoplasty. Scleral CLs were the most frequently fitted lens (285 eyes, 61%). All studies reported a significant improvement in visual acuity with CL correction. Most post-keratoplasty patients could wear CLs comfortably for 8 to 12 h/day. The rate of CL dropout ranged from 0% to 39%, mainly due to CL intolerance, discomfort, and graft rejection. Corneal graft rejection (18 eyes), conjunctival hyperemia (8 eyes), corneal epithelial trauma (5 eyes), graft edema (4 eyes), and microbial keratitis (3 eyes) were the most frequently reported complications.

CLs are effective for improving visual acuity following keratoplasty, with minor complications depending on the type of CL.