Reporte de caso: adaptación de lentes de contacto rígidos de apoyo escleral Custom Stable en paciente con distrofia corneal de Meesmann en Medellín, en 2025.

Abstract

Corneal dystrophies are hereditary, bilateral, symmetrical, and slowly progressive conditions associated with systemic or environmental factors (1). Meesmann corneal dystrophy is characterized by multiple gray epithelial vesicles resembling bubbles, which may cause photophobia, ocular irritation, and blurred vision due to corneal surface irregularities and scarring following vesicle rupture (2). While rigid contact lenses are commonly used to manage corneal irregularities, direct contact with the cornea can be counterproductive in such cases; therefore, scleral lenses offer a safe and effective alternative by resting on the sclera without touching the cornea (3). Objective: To document the fitting of a Custom Stable scleral rigid gas-permeable contact lens in a patient with Meesmann corneal dystrophy. Methodology: A descriptive observational cross-sectional study, presented as a case report, in which Custom Stable scleral lenses were fitted in both eyes. Case report: A 22-year-old male student, wearer of rigid gas-permeable contact lenses for five years without changes in the past three, was previously diagnosed with Meesmann corneal dystrophy in both eyes seven years ago. He presented with high myopia, significant astigmatism, and a visual acuity of counting fingers at 40 cm in both eyes. Results: After fitting the scleral lenses, the patient achieved 20/30 visual acuity for both distance and near vision, along with a significant improvement in visual comfort. Conclusions: Scleral lenses, by avoiding direct corneal contact and resting on the sclera, are an effective option for patients with intolerance to conventional designs or with corneal surface abnormalities, promoting successful adaptation and enhanced comfort.