Vision correction after keratoplasty: options of contact correction

Relevance The peculiarity of the surgical technique for correcting keratectasia and corneal dystrophies is that the allograft ribbon has a significant width and can affect the quality of vision, which has a great impact on a person's life, including its everyday and professional parts. The main goal of any keratoplasty is to restore the transparency of the cornea [1]. Modern technical equipment opens up wide opportunities for improving traditional and developing new effective methods in keratoplasty [2]. In the postoperative period, many factors can influence the process of transplant engraftment, which can further lead to deformation of the corneal surface and the formation of an irregular profile. Induced astigmatism to one degree or another is observed in almost 100% of cases, and in 30% of them, due to the impossibility of complete spectacle correction, it is necessary to use alternative methods, which will be discussed below. The most gentle methods of correction of post-keratoplastic astigmatism include optical ones - using glasses or contact lenses. Patients' assessment of their own visual function before and after treatment is extremely subjective and has little connection with quantitative indicators of visual acuity [3]. The reason for the impossibility of correcting postoperative astigmatism with glasses and soft contact lenses is the flattening of the transplant in the central zone of the cornea and steepening from the periphery in the area of ​​suture fixation after keratoplasty. In this case, rigid gas-permeable contact lenses, which are currently considered the "gold standard" of optical correction of irregular cornea [4], can be an alternative. Currently, scleral contact lenses (SCL) are the most popular in the field of contact correction of post-keratoplastic ametropia. Due to the presence of liquid in the sublens layer and the spherical surface of the lens, the SCL creates a new, more ideal optical system capable of leveling the irregular surface of the cornea to achieve high visual functions. Conclusion Visual rehabilitation using rigid gas-permeable contact lenses, in particular scleral contact lenses, capable of correcting the irregular profile of the cornea and achieving high visual functions, can prevent the need for surgical methods of optical vision correction after keratoplasty. Key words: keratoplasty; cornea; quality of vision; scleral lenses