Outcomes Of Contact Lens Fitting For Visual Rehabilitation After Healed Corneal Ulcers: A Retrospective Study

To establish the place of contact lenses in the management of patients with corneal scars after keratitis, this study evaluated visual outcomes and patient-reported tolerance of contact lens (CL) wear in individuals with complete healing following a corneal ulcer.

Department of Ophthalmology, Amsterdam University Medical Center (AUMC), Amsterdam, the Netherlands

This retrospective descriptive study included patients between January 2006 and January 2025 with a diagnosed corneal ulcer who, after complete healing, were referred for contact lens (CL) fitting to improve visual acuity (VA). Electronic medical records from Amsterdam UMC and Oculenti Contactlenzen were retrospectively reviewed to extract relevant clinical data.

Included patients were fitted with either corneal RGP or scleral lenses, primarily based on corneal irregularity, which was assessed via topography and slit-lamp examination, as well as the location of corneal scarring and the presence of evident keratitis sicca.

The key study variables are VA prior to CL fitting, VA with the CL, patient-reported complaints related to CL, and whether CL use was discontinued. VA was documented in logMAR and reported as median [IQR]. Data were tested for normality using the Shapiro–Wilk test and visual inspection of histograms and Q–Q plots.

19 patients were included: 15 were fitted with a corneal rigid gas permeable (RGP) lens and 4 with a scleral lens. Median VA improved from 0.40 [0.78] to 0.10 [0.12] logMAR with corneal RGP lenses and from 0.50 [1.00] to 0.31 [0.59] logMAR with scleral lenses. VA improved after CL fitting regardless of whether the ulcer was centrally or paracentrally located. 7 patients reported complaints during CL wear, and 3 eventually discontinued use.

Both corneal RGP and scleral lenses provide clinically relevant improvement in VA after complete healing of a corneal ulcer. Only a minority of patients discontinued CL wear, indicating good tolerance. These findings support the use of CL as an effective option for visual rehabilitation following corneal ulceration.