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Eye and Vision Care

After PK - Is a Soft Contact Lens Safe?

07/21/2010

Question:

Our son developed unilateral keratoconus and hydrops at the age of 12 and subsequently had a cornea transplant. The graft is clear but it`s taken 4 years and 3 more surgeries to reduce a very high post-transplant astigmatism. Some sutures remain but the surgeon has suggested a first attempt at contact lens fitting. They`re trying a soft contact lens, but I read that these carry an increased risk for compromising the graft via vascularization. Is it safe for a transplant patient to wear a soft contact (assuming it`ll even work)? We`re afraid he won`t be able to tolerate a rigid lens. I`ve read that there are new soft contacts that provide as much oxygen transfer as the RGPs, but I don`t think these are what the OD ordered. We`re afraid of risking the graft. We`d sure appreciate hearing your opinions on this!

Answer:

You are well versed on keratoconus and the subsequent grafts. The issue with soft contact lenses and vascularization is certainly warranted, however this is somewhat dependent on the soft contact lens material.

There are newer soft lens materials, as you have correctly read about, that are called silicone hydrogel lenses. These lenses typically allow more oxygen through the lens therefore decreasing the chance of vascularization.

The silicone hydrogels are somewhat but not extensively limited in terms of what is available (high powers, or high astigmatism correction may not be available).

I would ask your eye care professional about the material that has been chosen. Ask how much oxygen can pass through that particular lens.

The previous lens materials (hydrogels) may allow enough oxygen through the lens to prevent vascularization. Hopefully this is helpful.

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Response by:

Aaron  Zimmerman, OD, MS Aaron Zimmerman, OD, MS
Clinical Associate Professor of Optometry
College of Optometry
The Ohio State University