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

Norma Cárdenas Norma Cárdenas Norma Cárdenas Patricia Flores

Contact Lens Spectrum October 1, 2025

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

At a Glance

Category	Detail
Condition	Post-radial keratotomy with glaucoma
Key Mechanisms	Corneal irregularity, endothelial cell compromise, elevated intraocular pressure
Target Population	Patients with a history of radial keratotomy and glaucoma
Care Setting	Ophthalmology, multidisciplinary approach

Key Highlights

Patient experienced significant visual deterioration and reconsidered contact lens use.
Corneal GP lenses with reverse geometry were selected for fitting.
Final best-corrected visual acuity improved to 20/30 OD and 20/25 OS.
Monthly follow-ups over 6 months showed stable intraocular pressure.
Scleral lenses were contraindicated due to low endothelial cell density.

Guideline-Based Recommendations

Diagnosis

Assess visual acuity and corneal topography.
Evaluate intraocular pressure and endothelial cell density.

Management

Utilize corneal GP lenses with reverse geometry for fitting.
Implement pharmacologic treatment for corneal edema.

Monitoring & Follow-up

Conduct monthly follow-up visits to assess lens fit and ocular health.
Monitor intraocular pressure regularly.

Risks

Potential for further endothelial compromise with inappropriate lens choice.
Risk of elevated intraocular pressure with certain lens types.

Patient & Prescribing Data

Post-RK patients with glaucoma and corneal edema.

Corneal GP lenses provide high oxygen accessibility and visual quality without compromising IOP.

Clinical Best Practices

Prioritize ocular physiology and IOP control in lens selection.
Engage in a multidisciplinary approach for management.
Ensure close follow-up to optimize lens fitting and corneal health.

References

Menicon Co, Ltd.

Norma Cárdenas

Specialties: Specialty contact lenses

Bio: Norma Cárdenas, BOpt, MSc, is an optometry author with a focus on specialty contact lens fitting. Her published clinical case work in Contact Lens Spectrum addresses corneal gas permeable lens management for complex postsurgical corneas, including reverse-geometry GP lens fitting after radial keratotomy in the setting of glaucoma and endothelial compromise.

Norma Cárdenas

Specialties: Specialty contact lenses

Bio: Norma Cárdenas, BOpt, MSc, is an optometry author focused on specialty contact lens fitting for complex corneal cases. Her work includes clinical reporting on corneal gas permeable lens management for postsurgical irregular corneas, including post–radial keratotomy patients with concurrent ocular disease considerations such as glaucoma and endothelial compromise.

Norma Cárdenas

Specialties: Specialty contact lenses

Bio: Norma Cárdenas, BOpt, MSc, writes on specialty contact lens management for complex corneal conditions. In Contact Lens Spectrum, she coauthored a case report describing reverse-geometry corneal GP lens fitting for a post-radial keratotomy patient with corneal irregularity, endothelial compromise, and open-angle glaucoma. Her clinical writing focuses on lens selection and fitting strategies that account for ocular physiology, corneal health, and intraocular pressure control in postsurgical corneas.

Patricia Flores

Specialties: Specialty contact lenses

Bio: Patricia Flores, OD, is an optometrist whose clinical writing focuses on specialty contact lens management. In Contact Lens Spectrum, she co-authored a case report on fitting corneal gas-permeable lenses for a post–radial keratotomy patient with glaucoma, emphasizing ocular physiology, intraocular pressure control, and lens selection in complex corneal disease.