Scleral lens in a patient with ocular burn by alkalis

Abstract

A case is presented of a patient who suffered an ocular chemical burn by alkalis (lime) in the right eye, treated for cornea service and external diseases with subconjunctival bevacizumab injection and subsequent autologous limbal cell transplant. The evaluation by contact lens service, 4 years later, revealed decreased visual acuity, high irregular astigmatism and high order corneal aberrations that could not be corrected with glasses; likewise, biomicroscopy showed conjunctivalization between 3 and 9 in the upper region with diffuse opacity of the cornea, as well as neovascularization and severe dysfunction of the lacrimal system. As a result, treatment was performed as an adaptation of a support scleral lens in the affected eye, which achieved a recovery in visual acuity, decreased corneal optical aberrations of higher order and forming of a moist chamber for lenscornea interface, which improved the optical regularization of the ocular surface. The patient was functionally and therapeutically rehabilitated through scleral lens adaptation, also called Boston keratoprosthesis of the ocular surface.