Fitting of Corneal GP Lenses in a Post–RK Patient With Glaucoma

Overview

This report details the successful fitting of corneal GP lenses in a 55-year-old female post-RK patient with glaucoma and corneal edema, emphasizing the importance of visual improvement and comfort in the context of glaucoma management.

Background

Post-radial keratotomy (RK) patients often experience irregular corneal topography and visual deterioration, complicating contact lens fitting. The presence of glaucoma further complicates lens selection, as it is crucial to maintain intraocular pressure (IOP) stability while providing adequate vision correction. Specific challenges include managing corneal irregularities and ensuring lens design supports IOP control.

Data Highlights

Parameters measured include visual acuity, intraocular pressure, and comfort rating.

Key Findings

• The patient had a history of bilateral RK with significant visual deterioration and corneal irregularities.
• Corneal GP lenses with reverse geometry were selected to optimize alignment and oxygen permeability, specifically addressing the patient's corneal irregularities.
• Final best-corrected visual acuity improved to 20/30 OD and 20/25 OS after lens fitting.
• Intraocular pressure remained stable throughout the follow-up period.
• Monthly follow-ups over six months confirmed excellent lens comfort and no epithelial staining.

Clinical Implications

The fitting of corneal GP lenses in post-RK patients requires careful consideration of corneal health and IOP management, particularly in those with glaucoma. Ongoing monitoring of IOP is essential to ensure patient safety. A multidisciplinary approach involving cornea and glaucoma specialists is crucial for achieving optimal visual outcomes.

Conclusion

This case underscores the importance of tailored contact lens fitting in complex ocular conditions, highlighting the role of corneal GP lenses in maintaining visual acuity and IOP stability in post-RK patients with glaucoma. A multidisciplinary approach is essential for successful management.

References

1. Norma Cárdenas, BOpt, MSc, Contact Lens Spectrum, 2023 -- Fitting of Corneal GP Lenses in a Post–RK Patient With Glaucoma
2. Contact Lens Spectrum — GP Insights
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7. European Glaucoma Society – Terminology and guidelines for glaucoma, 6th Edition
8. Reduction of Intraocular Pressure and Glaucoma Progression: Results From the Early Manifest Glaucoma Trial | Glaucoma | JAMA Ophthalmology | JAMA Network