Accurately Predicting Extreme Reverse Geometry Scleral Lens Fit in Post PKP Cases with Corneo-Scleral Topography
Greg DeNaeyer, OD, FAAO, Donald Sanders, MD, PhD
Because of the extreme central flattening that can occur post-penetrating keratoplasty (PKP), these cases represent a unique scleral lens fitting challenge to optimize central and optical zone clearances. Standard fitting set diagnostic lenses are not designed to help with these extreme cases. In the past, multiple remakes have been required to optimally fit these patients. However with the advent of a novel Corneo-scleral topography system, the sMap3D, virtually fitting of even the most extreme ocular surfaces is now possible. This report summarizes 2 such cases that each required a 19D reverse geometry scleral lens and were fit and dispensed with no design remakes required.