CLINICAL-EXPERIENCE WITH GLUED-ON HARD CO NTACT-LENSES

Background: Persistent epithelial defects of the cornea are difficult to treat and can lead to severe complications such as melting processe s. Therefore the application of a glued-on hard contact lens as an art ificial epithelium has been recommended for many years, to protect the denuded corneal stroma. Materials and methods: This paper presents a 7-year retrospective study on the application of a hard contact lens a s an artificial epithelium. 46 patients with 50 eyes were treated with this method from january 1985 to march 1992. The majority of the pati ents suffered from most severe bums of the whole anterior eye segment (group I: n = 29 eyes) or of the cornea alone (group II: n = 13 eyes). A smaller number of patients (group III: n = 8 eyes) presented cornea l melting processes associated with other diseases. Results: The patie nts of group II and III showed the best outcome concerning spontaneous epithelization and prognosis for a penetrating keratoplasty. The trea tment with a glued-on hard contact lens was limited by the high rate o f complications (92%) in group I and II. In one third of the cases of group I these complications led to further surgical interventions (e.g . conjunctivoplasty of the globe). The results also show, that the app lication of a glued-on hard contact lens in patients with most severe eye bums is a long-term treatment (> one year). Conclusion: The poor p rognosis of corneas with severe healing problems of the epithelium can be improved by the application of a glued-on hard contact lens as an artificial epithelium. In severe burns of the whole anterior eye segme nt however, the treatment with an early keratoplasty should be conside red.