[Clinical experiences with adhesive hard contact lenses]

Persistent epithelial defects of the cornea are difficult to treat and can lead to severe complications such as melting processes. Therefore the application of a glued-on hard contact lens as an artificial epithelium has been recommended for many years, to protect the denuded corneal stroma.

This paper presents a 7-year retrospective study on the application of a hard contact lens as an artificial epithelium. 46 patients with 50 eyes were treated with this method from january 1985 to march 1992. The majority of the patients suffered from most severe burns of the whole anterior eye segment (group I: n = 29 eyes) or of the cornea alone (group II: n = 13 eyes). A smaller number of patients (group III: n = 8 eyes) presented corneal melting processes associated with other diseases.

The patients of group II and III showed the best outcome concerning spontaneous epithelialization and prognosis for a penetrating keratoplasty. The treatment with a glued-on hard contact lens was limited by the high rate of complications (92%) in group I and II. In one third of the cases of group I these complications led to further surgical interventions (e.g. conjunctivoplasty of the globe). The results also show, that the application of a glued-on hard contact lens in patients with most severe eye burns is a long-term treatment (> one year).

The poor prognosis of corneas with severe healing problems of the epithelium can be improved by the application of a glued-on hard contact lens as an artificial epithelium. In severe burns of the whole anterior eye segment however, the treatment with an early keratoplasty should be considered.