Corneal oedema in a unilateral corneal graft patient induced by high Dk mini-scleral contact lens

Abstract

Introduction: Scleral contact lenses are increasingly becoming accepted as the method of choice for visual correction of the irregular cornea. As such, cases have surfaced which demonstrate complications arising from mini-scleral lenses. Identification of these issues and adjusting fitting techniques accordingly is necessary for reducing the risks associated with mini-scleral lens wear.

Case report: A 58 year old Caucasian female was referred for rigid gas permeable contact lens fitting for correction of right irregular astigmatism post penetrating keratoplasty. After four months of successful mini-scleral contact lens wear, the patient experienced a graft rejection episode and treated accordingly, then refit with a new mini-scleral lens. Five months after the lens refit, the patient presented with complaints of hazy vision, and a diagnosis of lens-induced corneal oedema made.

Discussion: Increased awareness of the potential complications of mini-scleral lenses is necessary to encourage and enforce mini-scleral lens fitting techniques that meet the requirements of minimum vault but adequate protection of the compromised cornea.

Keywords: Contact lens; Corneal hypoxia; Graft; Graft rejection; Mini-scleral; Oedema; Penetrating keratoplasty; Rigid gas permeable.