Use of therapeutic hydrogel contact lenses in corneal melting disorders

During the past 20 years the use of hydrogel lenses as corneal 'bandages' has been a useful clinical development. Long-term extended wear of currently available devices, however, produces clinical hypoxia with significant risks of promoting corneal vascularization, corneal ulceration, and infectious keratitis. Therefore, long-term therapeutic use of currently available hydrogel lenses in eyes expected to retain useful vision is not a satisfactory strategy. In established corneal ulceration and melting disorders however, the risk-benefit ratio is favorable. Here, the judicious use of appropriately chosen and fitted therapeutic hydrogel lenses can tilt the balance in favor of healing with maintenance of ocular integrity. Such lenses should be uniquely selected on a case-by-case basis, and trial fit to each patient depending upon clinical circumstances: blanket use of 'one lens for all conditions', particularly mid-water hydrogels (disposable lenses), does not represent optimum treatment for the patient's corneal disorder.