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

To assess the role of various types of contact lenses (CL) after penetrating and lamellar keratoplasty, we reviewed all studies that were related to CL fitting in post-keratoplasty (full-thickness and lamellar) eyes between 1990 and 2024 by using relevant search keywords. The demographic data, indications for CL fitting, duration between keratoplasty and CL fitting, CL design and fitting methodologies, refractive outcomes, topographic and biomechanical changes, aberrometry, specular microscopy, corneal thickness, graft survival, and complications were analyzed. A total of 32 original studies and seven case reports were evaluated. All studies showed favorable refractive outcomes. Complications, if any, were managed successfully with conservative treatment and temporary discontinuation of lens wear. Most authors preferred to use large-diameter multicurve rigid-gas permeable lenses and scleral lenses over hydrogels and hybrid or piggy-back varieties, with an inclination toward late fitting due to multiple factors. The lenses did not have any adverse effect on graft survival. CLs are a useful tool in post-keratoplasty visual rehabilitation. However, patients require meticulous workup, a thorough fitting methodology, attention to associated problems, and close follow-up to monitor for complications.