Adaptación de lente de contacto rígido de apoyo escleral en paciente con queratoplastia penetrante secundaria a úlcera corneal por uso excesivo de lentes de contacto blandos, en clínica oftalmológica de Bogotá, Colombia. 2025. Reporte de caso

Abstract

Introduction: penetrating keratoplasty (PK) is a procedure used to restore corneal transparency in advanced cases of structural damage, with postoperative corneal irregularity being a common cause of visual decline. Scleral lenses represent an effective therapeutic tool for visual rehabilitation in these patients. Objective: to adapt a scleral contact lens in a patient with penetrating keratoplasty secondary to a corneal ulcer in the left eye caused by excessive use of soft contact lenses. Methodology: descriptive observational study in the form of a case report, in which an AirKone Scleral ATD lens was fitted in the left eye with satisfactory outcomes. Case Presentation: a 43-year-old female patient with a history of PK and intraocular lens implantation in the left eye secondary to a corneal ulcer. A comprehensive optometric evaluation, corneal tomography, and ocular surface assessments (Pentacam and Keratograph 5M) were performed. Based on the clinical findings, a definitive scleral lens was calculated and fitted following the manufacturer’s recommended parameters and applying the necessary clinical adjustments. Results: the adaptation of the AirKone Scleral ATD lens allowed the patient to achieve a visual acuity of 20/20 at distance and 0.50M at near, with good tolerance for 4–6 hours of daily wear in the left eye, without significant vascular compression or early complications. Conclusion: the adaptation provided visual rehabilitation and relief of dry-eye symptoms, though close monitoring is required due to the low endothelial cell count (901.7 cells/mm²). This case supports the scleral lens as a safe option in transplanted corneas when design, wearing time, and graft evolution are carefully controlled.