The use of rigid gas permeable contact lenses in scarred corneas

Perforating corneal injuries often result in scarred corneas in which adequate visual rehabilitation cannot be achieved with spectacles due to irregular corneal surface. In these eyes, the presence of aphakia often adds to the problem with the coexistence of anisometropia. In this study, rigid gas permeable (RGP) contact lenses were fit in 33 post-traumatic scarred corneas of 33 patients. Twenty-seven of the 33 eyes (82%) were successfully fit without complications for an average follow-up of 19.3 months. The success rate was observed to be lower (50%) for patients less than 10 years old, whereas it was 100% in patients older than 20 years. The six failures included two eyes with amblyopia and unsatisfactory visual acuity, two eyes in two patients who lacked motivation to use contact lenses, and two eyes that were contact lens intolerant. There was no significant correlation between the failure groups and the location and size of the corneal scar. The only contact lens related complication was punctate epithelial keratitis in three of the 33 eyes (9%). The results of this study indicate that RGP contact lenses are successful in the majority of patients (82%) with post-traumatic scarred corneas, especially in the adult age group, and may obviate corneal surgery in these patients.