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Corneal Transplant Patient Fit With Custom Scleral Lens

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We had the pleasure of seeing one of our keratoconus patients today for a specialty contact lens fitting for his right eye.

This patient has advanced keratoconus in both eyes. Last year, Dr. Stafeeva performed a corneal transplant on the right eye due to the advanced keratoconus disease. Many patients who have scarring on the front of their eye from keratoconus require a corneal transplant. She was waiting for the transplant to heal up on the right eye so she could perform cataract surgery (he had a visually significant cataract on the right eye as well).

In the meantime, we were focusing our efforts on his left eye to help improve the vision and the fit of the scleral lens. He has advanced keratoconus in the left eye with central scarring. He was fit with a scleral lens from another clinic, but when he saw us, the cornea had changed shape, and he advanced to the point where the cornea was touching the inside of the scleral lens. It is not safe for the scleral lens to touch the cornea, so it was important that we re fit him into a safer scleral lens design. He had a standard intraocular lens from cataract surgery in the left eye, as well as a scleral buckle from a prior retinal surgery. Since his eye was a very complicated case, we recommended a more custom scleral lens. A more custom fit scleral lens helps with lens comfort and can decrease redness.

We saw him in the summer of 2020 and ended up fitting his left eye into an EyePrint Prosthetic. With that lens, he was able to achieve 20/60 vision.

Today, we decided to fit his right eye into the Latitude scleral lens. We felt that because of his corneal transplant, along with the toric IOL in the right eye, a custom scleral lens would be the best option for him. With an over refraction of +2.00-3.50x116, he ended up achieving 20/15 vision! The Latitude scleral lens is a great choice for him because the custom fit of the lens will help to center and stabilize the optics of the scleral lens. This will allow for the best possible vision.

We are very excited for his Latitude scleral lens to arrive! With the amount of astigmatism, we did educate him that it could take 1 or 2 additional lenses to center the optics, but we do feel very good about the fact that he will be able to achieve such great vision.

Thanks for Dr. Stafeeva for thinking of us for this fun case!

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