Rigid gas permeable extended wear (RGPEW) for the postoperative patient: a review and clinical observations.

BACKGROUND

Contact lenses are often the indicated method of correction following cataract extraction without implantation of an intraocular lens and following penetrating keratoplasty. Unfortunately, many patients who stand to benefit from contact lens wear are unable or lack the motivation to perform proper lens hygiene. Thus, extended lens wearing schedules using soft and rigid lens designs are often utilized.

METHODS

Following a review of the literature regarding extended wear rigid lenses (PMMA and oxygen permeable) for the aphakic patient, this paper presents results of fitting high DK (92 x 10-11) rigid contact lenses worn from 1-2 months prior to removal on 11 patients (six with aphakia, five following penetrating keratoplasty). All subjects with aphakia were considered to be unsuccessful with soft aphakic extended wear (SEW). Subjects in the penetrating keratoplasty group were new to contact lens wear.

RESULTS

These data show that 60 percent of aphakic patients considered to be unsuccessful with SEW may be successful with rigid gas permeable extended wear (RGPEW). The predicted success with RGPEW following penetrating keratoplasty was lower at 20-40 percent.

CONCLUSIONS

RGPEW should be considered for the postoperative patient who stands to benefit from the optical advantages of contact lenses but is unable or not motivated to perform the necessary lens hygiene. Patients who experience lens awareness or become intolerant to SEW due to corneal edema are potential candidates for RGPEW.