Clinical evaluation of rigid gas permeable contact lenses and visual outcome after repaired corneal laceration.

OBJECTIVE

To evaluate the clinical value of rigid gas permeable contact lenses (RGPCLs) in patients with traumatic corneal scarring and address implications of primary corneal repair.

METHODS

Eighteen subjects with a history of corneal laceration were fit with RGPCLs. Scar locations were divided into two zones; each patient was examined using Pentacam. Entering data included uncorrected visual acuity (UCVA), spectacle-corrected visual acuity (SVA), time between injury and RGPCL fitting, location and size of scar, and amount of corneal astigmatism. Follow-up data included RGPCL visual acuity (RGPCLVA), RGPCL-related complications, and dropout characteristics. Visual acuity values were converted to logMAR for analysis.

RESULTS

No serious complications occurred. The average time between suture removal and RGPCL fitting was 5.7±5.5 months. Average corneal astigmatism was -3.44±2.09 diopters. One subject had developed corneal ectasia. RGPCLVA was more than 0.1 in three subjects: one experienced primary corneal repair complications, and two subjects (<10 years) developed amblyopia. In both zones, the difference in RGPCLVA outcome between zone I and zone II was not statistically significant (F=0.060, P=0.809). The difference between SVA in zones I and II was found to be statistically significant (F=6.131, P=0.026), as were the differences between SVA and RGPCLVA (F=8.598, P=0.010). The scar size had no significant influence on RGPCLVA, SVA, or UCVA. Four participants (22.2%) were successfully fit. Dropout characteristics included ocular discomfort, inconvenience, parental apprehension, and low motivation.

CONCLUSIONS

Rigid gas permeable contact lens is an ideal method for evaluating visual potential in patients with traumatic corneal astigmatism. Pentacam examinations of those patients with poor RGPCLVA can help an ophthalmologist find and understand existing problems in suture techniques.