A Case of a Rigid Gas Permeable (RGP) Contact Lens Found as a Foreign Body under the Upper Tarsal Conjunctiva

PURPOSE: To report a case of removing a rigid gas permeable (RGP) contact lens that was found under the upper tarsal conjunctiva after five or more years. CASE SUMMARY: A 60-year-old female patient visited our Department of Ophthalmology due to the irritation of a foreign body sensation in her right eye that had been present for approximately two weeks. The patient started wearing RGP contact lenses 8 years previously. Five years prior, somebody struck her in her right eye, and the patient thought that she lost the RGP lens for her right eye. At that time, she visited the clinic and was diagnosed with corneal erosion, but nothing else in particular. Afterward she continued to visit the clinic 2 to 3 times per year for regular checkup, but nothing notable was found. The best corrected visual acuity and IOP at the initial visit were 0.8 and 27 mm Hg in the right eye and 0.8 and 23 mm Hg in the left eye, respectively. Mild swelling and erythema along the right upper eyelid were identified. As we everted the upper eyelid, a 4 x 4 mm sized, transparent, oval-shaped foreign body with a concave dented center was found. Under the local anesthesia, the foreign body under the upper tarsal conjunctiva was removed and we presumed that the foreign body was the RGP contact lens that had stuck under the conjunctiva due to the incident 5 years prior. After removal, the patient did not express any discomfort and nothing extraordinary was found during the 6 months of follow-up.

Vision-Correction Effect of RGP Contact Lens in Patients With Corneal Opacity Following Repaired Corneal Perforations

PURPOSE: To investigate the effect of rigid gas permeable (RGP) contact lenses in patients with corneal scar and opacity following repair of corneal perforations. METHODS: A total of 10 eyes from 10 patients undergoing repair of corneal perforating injuries and fitted with RGP contact lenses were examined in the present study. The mean postoperative 3-month visual acuities, refraction, corneal topography, keratometry, best corrected visual acuities with spectacles and RGP lenses at an average of postoperative 3 months were evaluated. RESULTS: Eight eyes had corneal opacities at the central and 2 eyes at the peripheral portion. Four patients had previous cataract surgery or cataract surgery with intraocular lens insertion due to traumatic cataract. The mean postoperative 3-month LogMAR visual acuity was 1.14 +/- 0.53. Corneal topography showed irregular astigmatism in all patients and the mean keratometric astigmatism was 4.03 +/- 4.06 diopters. The mean best corrected LogMAR visual acuities with spectacles was 0.91 +/- 0.64 and with the RGP contact lens was 0.25 +/- 0.35. A comparative analysis of improvement in visual acuity with the RGP contact lens over spectacle correction was found to be statistically significant (p = 0.005). Patients wore the lenses for more than 6 hours daily for the mean follow-up period (12.10 +/- 7.80 months). CONCLUSIONS: In patients with corneal scar and opacity following repair of corneal perforations, RGP contact lens fitting should be considered first before surgical corrections such as keratoplasty.