Objective:

To evaluate the use of custom specialty soft contact lenses for visual rehabilitation in patients with advanced corneal ectasia post-penetrating keratoplasty, particularly in cases where traditional rigid lenses are intolerable.

Approach:

• Case Description: A 48-year-old female with bilateral keratoconus and a history of penetrating keratoplasty presented with discomfort in her habitual soft contact lenses, specifically noting lens awareness in the left eye. She had previously experienced dropout from corneal GP lens wear.
• Follow-Up: At follow-up visits over 7 years, the patient maintained stable vision and comfort with the specialty soft lens, with slight adjustments to parameters due to changes in her corneal condition.

Key Findings:

• Custom specialty soft lenses can be a viable alternative for patients intolerant to rigid lenses.
• The patient achieved stable vision and comfort with the specialty soft lens over 7 years.
• The lens parameters were adjusted slightly over time due to changes in the patient's corneal condition.

Interpretation:

The use of specialty soft lenses may provide an alternative for managing irregular corneas in patients who have difficulty with traditional rigid lenses.

Limitations:

• The case study is based on a single patient experience.
• Long-term outcomes and broader applicability to other patients with similar conditions are not established.

Conclusion:

The patient continues to wear the specialty soft lens comfortably for extended periods, indicating its effectiveness for managing irregular corneas.

Sources:

• Lindsay A. Sicks, OD