Many patients underwent Radial Keratotomy (RK) surgery to correct myopia and astigmatism during the early stages of refractive surgery. Because of the aggressiveness of the procedure, those having undergone RK surgery can be left with some refractive error in the form of nearsightedness, farsightedness, or (irregular) astigmatism. Those with irregular astigmatism experience blurred, distorted vision loss which cannot be corrected with glasses. It is among the more serious and frequently occurring complications following corneal refractive surgery.
Matthew, a 52-year-old teacher, underwent bilateral RK surgery in 1995. Though the initial results were positive, within two years his vision deteriorated. He developed corneal ectasia, and complained of blurred vision, discomfort, and red eyes when wearing contact lenses.
The slit lamp examination revealed damaged corneas which had severe staining along the incision lines and around the cornea at the limbus. This was a result of the fit of the GP lenses he was wearing at the time. They were touching the anterior elevations of the cornea and did not allow for enough tear exchange.
Fitting a scleral lens was the best option to treat Matthew’s damaged corneas, alleviate discomfort and improve his vision.
At the one-year visit, the patient improved both visual acuity and quality. The fitting of a well-designed semi-scleral GP contact lens filled with a saline solution created a healthy environment behind the lens, which in turn allowed the cornea and limbus to heal. The scleral lenses also helped protect the RK incisions from further abrasions caused by blinking.
As this case demonstrates, patients having developed irregular corneal surfaces following refractive surgery can benefit from a customized scleral contact lens design to improve their wearing comfort and vision.