This case report describes a 34-year-old man with a history of keratoconus and corneal grafting in both eyes. He had been successfully wearing a Rose K XL contact lens in the right eye and a Biofinity toric lens in the left eye. At his follow up appointment, his contact lens parameters were modified and vision, centration, movement, and coverage were assessed to be good with both lenses. Topography showed the grafts to be intact in both eyes.

1. Case report of CL
Fitting in post
graft cornea
MEENAKSHI
M.OPTOM PR 003

2. Case details
 Nilabhra Banerjee
 34 year old gentleman visited to clinic for contact lens
follow up check up.
 Diagnosed Keratoconus : RE 20 year back and LE 15 year
back
 BE keratoplasty done : RE in 2003 and LE in 2009
 General health : Good
 Medication: Optive e/d X Tid
 There was no known drug allergy

3. CL history
 H/O wearing BE Toric soft contact lens after keratoplasty of left eye in
2009 for about 3 years.
 Shifted to RGP contact lens in 2012.
 LE was again shifted back to Toric soft contact lens but continued RGP
lens in RE till January 2019
 In April 2019 RE was shifted to ROSE K XL as he was having irritation in
RE while wearing RGP due to CLPC
 On the follow up visit the parameter of ROSE K XL was modified
 Current Contact lens parameters:
OD: 7.00mm/-8.50D/14.60/-0.50/Rose K XL
OS: 8.7mm/-4.50/-1.75X170/14.50/Biofinity toric
 Using Rose k XL since 6 months in RE and Biofinity toric since 2 years in
LE

4. Cl history
 Wearing Time: Rose K XL 6hrs/ day breaks after 3 hours for
30 mins
Biofinity toric 10 hrs/day
 Solution: OD: RGP sparkle for cleaning and contacare PS as
saline
OS: Biotrue

5. RIGHT EYE LEFT EYE
UNAIDED VISION 6/60 6/60
PINHOLE 6/6 6/6
VISION WITH
Contact lens
6/6- 6/6
SUBJECTIVE
ACCEPTANCE
-1.00/-5.50 X 100 -5.0/-1.75 X 170
BCVA 6/6 6/6
NEAR VISION N6 N6

6. Slit-lamp finding:
Structures Right eye Left eye
Lids Flat Flat
UTC Papillae++ Papillae ++
Cornea Graft Intact Graft intact
Sclera Normal Normal
Iris Normal Normal
Pupil RRTL RRTL
Lens Clear Clear
Anterior chamber IV IV
TBUT 5-6 sec 5-6 sec
6

7. OD

8. SIM K 1 SIM K2 MEAN
OD 8.13
mm(41.51D)@98
7.13mm
(47.33D)
7.63mm
(44.23D)
OS 7.60mm
(44.4D)@159
7.40mm
(45.60D)
7.50mm(
45.0D )

9. OD TOPOGRAPHY

10. OS TOPOGRAPHY

11. CL fitting in OD
RIGHT EYE
7.00/ -8.50/ 14.60/ Lift-
0.50/Rose K XL
VISION with CL
After 1 hour of
adaptation
6/6-
Over refraction -0.50 = 6/6 N6
Centration Well centred
Edge lift 0.8 mm
Coverage Full and adequate
Movement 0.2 mm

12. CL fitting
in OS
LEFT EYE
8.70/ -4.50/-1.75 x 170
14.50/ Biofinity toric
VISION with CL 6/6
Over refraction Plano
Centration Well centred
Coverage Full and adequate
Movement 0.2-0.3 mm
LAG Up gaze
Horizontal
1.5mm
1.0mm
Rotation No rotation
Orientation 6 O'clock