5 Key Takeaways

• 1

  Scleral lenses provide optical rehabilitation and ocular surface protection for patients with compromised corneas.

• 2

  A 68-year-old female with a failing penetrating keratoplasty experienced visual decline and glare despite previous scleral lens use.

• 3

  A customized scleral lens made from high Dk material improved oxygen delivery, reducing corneal edema and supporting graft viability.

• 4

  After modifications, the final lens achieved stable performance, improving the patient's best-corrected visual acuity to 20/150.

• 5

  This case highlights the importance of oxygen permeability and customized lens design in managing endothelial decompensation.