ArticleUse of Scleral Lenses and Miniscleral Lenses After Penetrating KeratoplastyBarnett, Melissa O.D., F.A.A.O.; Lien, Vivian M.D.; Li, Jennifer Y. M.D.; Durbin-Johnson, Blythe Ph.D.; Mannis, Mark J. M.D.Author Information UC Davis Health System Eye Center, Sacramento, CA. Address correspondence to Melissa Barnett, O.D., F.A.A.O., UC Davis Health System Eye Center, 4860 Y St, Suite 2400, Sacramento, CA 95817; e-mail: [email protected] The authors have no conflicts of interest to disclose. Supported by Research to Prevent Blindness. Accepted April 06, 2015 Eye & Contact Lens: Science & Clinical Practice: May 2016 - Volume 42 - Issue 3 - p 185-189 doi: 10.1097/ICL.0000000000000163 Buy Metrics Abstract Purpose: To examine the clinical outcomes of scleral lenses for visual rehabilitation after penetrating keratoplasty (PK). Methods: A retrospective review was conducted for 34 patients (48 eyes) who had a history of prior PK and were fit with scleral lenses between October 2009 and December 2013 at the UC Davis Eye Center. Results: The most common initial indication for PK was keratoconus in 27 eyes (56%). Thirty-three eyes (69%) had previously been fit with other types of contact lenses, with small-diameter rigid gas-permeable lenses being the most common. The improvement in best-corrected visual acuity with a scleral lens compared with prior spectacle refraction or other contact lens was a mean of two best-corrected visual acuity lines. Forty-four eyes (91.7%) achieved functional vision with best scleral lens-corrected visual acuities of 20/40 or better. Patients who continued wearing scleral lenses were significantly more likely to report “good” subjective vision compared with patients who abandoned scleral lens wear (P=0.009), although change in objective best-corrected visual acuity did not differ significantly. There were no cases of infectious keratitis. Six eyes (12.5%) developed graft rejection; 3 were able to resume scleral lens wear. Nineteen eyes (39.5%) discontinued scleral lens wear for various reasons, the most common reason for discontinuation of lens wear was difficulty with scleral lens insertion or removal (8 eyes, 42.1%). Conclusion: Scleral lenses are effective and safe in patients who have had PK. There was a mean gain in visual acuity, with the majority of patients achieving 20/40 vision or better. The patient's subjective perception of vision was a significant factor in determining whether scleral lens wear was continued or abandoned. © 2016 Contact Lens Association of Ophthalmologists, Inc.