Due to the high tech nature of the work that we do, very few of our “high need” patient population ever need to undergo corneal transplant surgery.
Scleral Lenses and Corneal Transplant Surgery
Due to the high tech nature of the work that we do, very few of our “high need” patient population ever need to undergo corneal transplant surgery. However, we need to appreciate the fact that having a corneal transplant is not always a smooth, problem free procedure. Almost every eye that undergoes corneal transplant surgery will have an irregular, distorted ocular surface. The uncorrected vision that almost every patient with a corneal transplant will experience will be very poor. Eyeglasses and conventional contact lenses may improve the vision in this eye to some extent. It has been my experience that a well designed and fit scleral lens will provide the patient with a transplanted cornea with the best vision possible.
There are several reasons why this is so important:
1. All transplanted corneas are very irregular and distorted. Most of the donor corneas once sutured in place will have a tilt. Soft contact lenses will not provide clear vision because the soft lens will take on the same contour as the transplanted cornea. Regular hard contact lenses will be very unstable on this type of eye and will be very uncomfortable to wear. Only a well designed scleral lens will be stable on this type of eye as it will not move with the eye.
2. The post-surgical ocular surface of an eye with a transplanted cornea is often compromised and dry. In addition, the blinking action of the eyelids against the irregular corneal surface may prove to be very irritating. Only the scleral lens will keep the eye moist and protect the cornea from the environment and the blinking action of the eyelids. The scleral lens will not touch the cornea. Instead, the scleral lens will vault over the transplanted cornea and rest on the white portion of the eye (the sclera). The space between the back surface of the scleral lens and the front surface of the cornea is filled with unpreserved sterile saline solution. In other words, the front surface of the eye is always in a liquid environment. Vision and comfort is almost always excellent.