Transplanted Keratoconus Patient with Hydrops Receives GVR Scleral Lens

In the top photo, I am on the left, our student extern, Jennifer Vicente is on the right and our patient, Maria, is in the center. Maria visited our office recently from Montevideo, Uruguay. In 1977, she underwent corneal transplant surgery in her left eye due to keratoconus. Because her left cornea is so profound, she was not able to tolerate any type of contact lens. Of course, eyeglasses were not able to correct her vision either. For all of these years, this eye was essentially blind without any functional vision. In 2010, this eye developed a condition known as “hydrops”. This condition is created when the most posterior corneal membrane tears allowing fluid (aqueous) from within the eye to enter the cornea. When this occurs, the cornea can become cloudy creating additional vision loss. Several weeks ago, we fit this eye with a GVR Scleral lens which is providing clear (20/30) comfortable vision in this eye for the first time in almost 40 years. The 2nd photo below shows a profile view of Maria’s left transplanted cornea. Note how far out the center of gravity is. For this reason, the only lens that will allow Maria to see with this eye is a very large scleral lens.The next photo is a frontal view of the scleral lens on Maria’s left eye. The last photo is a greatly enlarged image of the lower half of Maria’s left transplanted cornea. The curved gray area going around the cornea outlines the junction between the host and donor cornea. Look carefully and you will note a bowl-shaped gray outline extending from about 7:00 O’Clock to the center of the cornea just below the pupil. This is the torn posterior corneal membrane which took place in 2010. I expect Maria to be able to wear her scleral lens comfortably and with excellent vision for many years.

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