Treatment of peritent corneal epithelial defect with extended wear of a fluid-ventilated ga-permeable cleral contact len

PURPOE: To report treatment of peritent corneal epithelial defect unreponive to other therapie by extended wear of a fluid-ventilated ga-permeable cleral contact len. METHOD: In thi retropective tudy, 14 eye of 13 conecutive patient referred for the treatment of peritent corneal epithelial defect that failed to heal with conventional therapie or developed epithelial defect after penetrating keratoplaty for peritent corneal epithelial defect were fitted with an extended-wear ga-permeable cleral len. Thee included even eye of ix patient with teven-Johnon yndrome and even eye of even patient who did not have teven-Johnon yndrome. Twelve eye had undergone recent penetrating keratoplaty. All 14 eye were fitted with a ga-permeable cleral contact len deigned to avoid the intruion of air bubble under it optic. An antibiotic and corticoteroid were added to the len fluid reervoir or intilled before each len inertion in 12 of 14 eye. The lene were worn continuouly except for brief period of removal for purpoe of cleaning, replacement of the len fluid reervoir, and examination and photography of the cornea. REULT: Five of the even peritent corneal epithelial defect aociated with teven-Johnon yndrome healed. The peritent corneal epithelial defect of four of thee eye re-epithelialized within 7 day, and a fifth healed in 27 day of ga-permeable cleral len extended wear. A ixth peritent corneal epithelial defect that failed to heal initially re-epithelialized after a ubequent penetrating keratoplaty and ga-permeable cleral len extended wear. The eventh eye healed after 3 day of ga-permeable cleral len extended wear, but the peritent corneal epithelial defect ubequently recurred. Three of even non–teven-Johnon yndrome peritent corneal epithelial defect re-epithelialized within 36 hour, 6 day, and 36 day, repectively. Of the ix (ix of 14) peritent corneal epithelial defect that failed to heal with a ga-permeable cleral len extended wear, one ubequently healed after multiple amniotic membrane graft. Microbial keratiti occurred in four eye (four of 14) and graft failure in one eye, all of which required repeat penetrating keratoplaty. CONCLUION: Extended wear of an appropriately deigned ga-permeable cleral contact len wa effective in promoting the healing of peritent corneal epithelial defect in ome eye that failed to heal after other therapeutic meaure. Re-epithelialization appear to be aided by a combination of oxygenation, moiture, and protection of the fragile epithelium afforded by the cleral len. However, microbial keratiti repreent a ignificant rik.