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Objective: To evaluate the clinical effect of rigid permeable contact lenses (RGPCL) in the correction of irregular astigmatism after keratoplasty. Methods: Retrospective case study. From June 2012 to December 2016, 31 patients (37 eyes) who underwent corneal transplantation were tested and fitted with RGPCL. The patients' data of primary disease, interval from keratoplasty to contact lens fitting, uncorrected visual acuity, best spectacle-corrected visual acuity, best RGPCL-corrected visual acuity, contrast visual acuity before and after RGPCL wear, corneal topography and corneal endothelium parameters before and after RGPCL wear were collected, including ocular complications and comfort of contact lenses. Results: Among the 31 patients, 24 were male and 7 were female, with age of (31.3±5.8) years. The mean interval between grafting and initial contact lens fitting was (4.6±2.3) years. Uncorrected visual acuity, best spectacle-corrected visual acuity, and best RGPCL-corrected visual acuity were 0.81±0.21, 0.54±0.13, and 0.10±0.07, respectively ( t= 7.170, 16.617, 17.866; all P< 0.05). The average astigmatism was -5.76±2.23 D and -0.83±0.47 D before and after wearing RGPCL ( t= 8.531, P< 0.05). After wearing RGPCL, the contrast visual acuity of 100%, 25%, 10%, and 5% was increased from 0.95±0.33, 1.18±0.21, 1.40±0.00, and 1.40±0.00 to 0.12±0.15, 0.37±0.17, 0.65±0.25, and 0.96±0.29, respectively ( t= 5.972, 8.473, 9.243, 5.104; all P< 0. 05). There were no obvious changes of corneal endothelium parameters during the observation period. No obvious corneal allograft rejection or other complications occurred, and 94.6% (35/37) of the patients felt comfortable with wearing RGPCL. Conclusions: RGPCL wear is safe and effective in correcting irregular astigmatism after corneal transplantation. We can obtain good corrected vision and improve contrast visual acuity, especially for patients who can not wear spectacles. (Chin J Ophthalmol, 2019, 55: 413-418) .

Most of the 19 cases of high myopia with esotropia fixus had the refractive error in childhood while esotropia fixus set in progressively during middle age. The eyeball was fixed in a position of marked adduction, and the forced duction test was positive. Electromyography showed normal innervation of the medial and lateral recti. Contracture of the medial rectus and thinning of the lateral rectus were observed during surgery. Histopathological examination revealed degeneration and fibrosis in the medial rectus. Etiology was not clear. Tenotomy of the medial rectus or that of the inferior rectus in addition, with fixation of the lateral rectus tendon to the lateral orbital rim produced satisfactory corrective results.

The scleral encircling or explant procedures for treatment of retinal detachment usually lead to post-operative strabismus, due to traumatic muscular adhesion to the globe, explant interference with muscular function, nerve damage and muscular paralysis, excessive or prolonged stretching of the muscle and surgical muscular reattachment at an improper site. In addition, there may be muscular atrophy or cicatrizing transformation due to compression. In 3 patients, the authors made use of the cicatricial tissue in place of the original muscle with or without surgical adjustment of the other ocular muscles. Satisfactory cosmetic result and ocular motility were obtained in all 3 cases.