Complications associated with aphakic contact lenses.

Complications associated with rigid contact lenses are more frequent in aphakia. The limited dexterity of older patients not only may prove an insurmountable barrier to the mastery of daily contact lens insertion and removal, but also may produce significant direct eye trauma, its seriousness determined by the integrity of the cataract wound. Since prolonged wear of aphakic contact lenses is the rule rather than the exception, the risk of irreversible corneal changes such as vascularization and erosions is greater. A poorly fitted aphakic contact lens that does not permit adequate oxygenation of all corneal areas makes such complications even more likely to occur. Decreased corneal sensitivity associated with cataract surgery permits continued wear of a poorly fitted lens, which does not allow the cornea to recover between wearing periods. Detection of keratoconjunctivitis sicca, more prevalent in the older age group, may prevent the associated complications of corneal erosion, iritis, and infection. Complications of aphakic contact lenses can be controlled by patient instruction, appropriate contact lens adjustments, and regularly scheduled follow-up examinations.