Objective:

To report a case of conjunctival prolapse in a post-penetrating keratoplasty patient wearing a scleral lens and to discuss the modifications made to the lens design to address the issue, highlighting its clinical significance.

Key Findings:

• Conjunctival prolapse was linked to excessive central vault and improper haptic alignment, indicating the need for careful fitting.
• Initial lens fitting resulted in excessive clearance and negative pressure under the lens, which could lead to complications.
• Redesigning the lens improved the patient's condition by reducing central vault and optimizing haptic placement, suggesting a need for tailored adjustments.

Interpretation:

Conjunctival prolapse in scleral lens wearers can be mitigated through careful lens design adjustments, particularly in patients with previous corneal grafts, emphasizing the importance of individualized fitting.

Limitations:

• The case study is based on a single patient, limiting generalizability; further studies are needed to validate findings.
• Long-term outcomes of the lens modifications have yet to be fully assessed, highlighting the need for ongoing evaluation.

Conclusion:

Adjustments to scleral lens design can effectively address conjunctival prolapse, enhancing comfort and stability for post-keratoplasty patients, underscoring the importance of personalized lens design.