Managing a patient with scleral lens wear following Penetrating Keratoplasty (PKP), high irregular astigmatism and large anisometropia.

Visual rehabilitation following penetrating keratoplasty (PKP) is the primary indication for approximately 15% of all scleral lens fittings and significant irregular astigmatism is present in 62.9% of patients after this technique. Contact lenses (CL) can improve visual function in these patients, especially scleral lens (SL) since the lens is very stable and can vault the graft--host interface, minimizing potential mechanical irritation from lens movement or bearing and reducing the potential for graft rejection or failure and correcting a high irregular corneal astigmatism. The other indication of SL is a monocular correction after PKP because of usually large anisometropia and aniseikonia induced. The combination of these two factors leads to success and indication to fit SL in these complex cases. This is a case report on a keratoconus patient suffering from irregular astigmatism, large anisometropia, and generalized leukoma after a monocular PKP infection, with the main goals of improving best-corrected visual acuity (BCVA) and reduced aniseikonia with SL. [ABSTRACT FROM AUTHOR]