At Westmead Eyes Optometrists, we are experienced in the fitting of post graft contact lenses.
In a corneal transplant, the diseased area of cornea is removed from the patient’s eye, and replaced with one from a donor cornea. There are many types of corneal transplants procedures performed. The type of transplant required is based on each patient’s ocular condition and current disease state.
Many patients think that a corneal graft is the end solution that will fix their eyes. Rejection of the graft is not uncommon, especially in patients who have had injuries, infections, or previous operations on the eye. The risk of rejection is to be assessed for each particular case. Should rejection occur, vision is usually poor and replacing the graft needs to be considered.
Corneal grafts are rarely lifelong, and data from the Australian Corneal Graft Registry indicates that 50% of grafts fail within the first 10 years, and 85% of grafts fail within the first 20 years. This figure is a little lower for grafts due to a diagnosis of keratoconus, with a 50% failure rate within the first 20 years. The longer you can have no problems with your first graft, the better. Replacement grafts do not do as well as the first graft in the long term and it is best to avoid corneal graft rejection. It is important to maintain a healthy corneal graft for as long as possible.
Why are contact lenses needed after a corneal grafts or corneal transplant?
After certain corneal transplants, the front surface of the eye becomes irregular in shape. Astigmatism is very common, and this irregularity can also change if there are stitches left within the cornea. The irregular cornea can cause distorted vision, even with the best glasses. Specialty contact lenses such as scleral lenses or gas permeable lenses can significantly improve vision.
Post Graft Contact Lens Fitting
Our optometrists are experienced in contact lens fitting for patients who have undergone corneal transplants (post graft contact lenses). Post graft contact lenses are complicated to fit, but our advanced equipment is designed to assess your unique eye shape, allowing us to provide personalised recommendations for each of your eyes.
When considering the precise fitting a contact lens over a corneal graft, several critical factors come into play:
- Type of corneal graft: A corneal graft can be either a full-thickness Penetrating Keratoplasty, a layered/partial thickness Lamellar Keratoplasty replacing the middle layers of the cornea, or an Endothelial Keratoplasty replacing the deeper back layers of the cornea. The appropriate lens design needs to be considered for the type of graft you have.
- Keeping the graft safe: It is imperative to make sure that the lens does not touch the edge of the graft, so it stays healthy.
- A perfect fit: We work hard to make sure the lens fits just right on your eye, balancing how it sits in the center and around the edges. To do this, we use 3D imaging technology to map out your eye shape and create a completely customised lens design.
- Enough oxygen: Your corneal tissue still needs to get the oxygen it requires even with the lens on. We only use the most highly oxygen permeable lens materials for our graft patients and monitor your graft closely for possible swelling and rejection episodes. We may also alter the thickness of the lenses, or add fenestrations to increase oxygen supply to your cornea.
- Addressing concurrent eye conditions: We also look at any other eye problems you might have, as certain conditions can affect your grafts performance.
To arrange an appointment for post graft contact lens fitting please contact us. A referral is not required.