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Bulgarian Review of Ophthalmology

A new approach for management of the anterior eye surface using the `oldest` contact lenses concept

Maria Rumenova Boyadzhieva



The aim of this article is to track and analyze the effects of therapeutic soft and rigid contact lenses used pre-, intra- and postoperatively


Therapeutic contact lenses were applied to 67 eyes in 56 patients. An assessment of subjective symptoms was made pre- and postoperatively regarding pain, foreign body sensation, tearing, and objective symptomatology including visual improvements and corneal architecture. Patients were divided into two groups with respect to the type of contact lenses - 47 patients with soft TCL (therapeutic contact lens) and 9 patients with rigid TCL (mini-scleral contact lenses 15 mm in diameter).


In terms of comfort and tolerance, 100% of the patients reported pain reduction and a subjective improvement regarding different levels of discomfort. In 32 patients the vision has improved by 0.1-0.2 and structural reconstruction of the anterior ocular surface was diagnosed in 70% of the patients. Furthermore, an improvement in quality of life was reported by 89% of the treated patients.


The study demonstrates that therapeutic contact lenses have significant benefits. For the time being, application of TCL in Bulgaria is mainly limited to soft, silicon-hydrogel contact lenses. A current study has highlighted the advantages of implementing mini-scleral lenses especially in cases with poor prognosis


anterior eye surface, therapeutic contact lenses

Full Text


Kobashi H, Ciolino JB. Innovative Development of Contact Lenses. Cornea. 2018 Nov;37 Suppl 1:S94-S98. doi: 10.1097/ICO.0000000000001725.

Thoft RA. Therapeutic Soft Contact Lenses. Int Ophthalmol Clin. 1986;26(1):83-90.

Rubinstein MP. Applications of contact lens devices in the management of corneal disease. Eye (Lond). 2003;17(8):872-6. doi: 10.1038/sj.eye.6700560.

Shah C, Raj CVS, Foulks GN. The evolution in therapeutic contact lenses. Ophthalmol Clin N Am. 2003;16(1):95-101, vii.

Segal O, Barkana Y, Hourovitz D, Behrman S, Kamun Y, Avni I, et al. Scleral contact lenses may help where other modalities fail. Cornea. 2003;22(4):308-10.

Maulvi FA, Soni TG, Shah DO. A review on therapeutic contact lenses for ocular drug delivery. Drug Deliv. 2016;23(8):3017-26. doi: 10.3109/10717544.2016.1138342.

Faulks GN. Therapeutic contact lenses:The armamentarium. Rev Ophthal. 2003. Available at:

Ong HS, Dart JK. Managing ocular surface disease: a common-sense approach. Community Eye Health. 2016;29(95):44-6.

Pullum KW, Whiting MA, Buckley RJ. Scleral contact lenses: The expanding role. Cornea. 2005;24(3):269-77.

Romero-Rangel T, Stavrou P, Cotter J, Rosenthal P, Baltatzis S, Foster CS. Gas-permeable scleral contact lens therapy in ocular surface disease. Am J Ophthalmol. 2000;130(1):25-32.

Kobashi H, Ciolino JB. Innovative development of contact lenses. Cornea. 2018 Nov;37 Suppl 1:S94-S98. doi: 10.1097/ICO.0000000000001725.

Steele CF. Fitting and management of therapeutic contact lenses. Available at:

Kanpolat A, Uçakhan ÖÖ. Therapeutic Use of Focus® Night & DayTM Contact Lenses. Cornea. 2003;22(8):726-34.

Jackson AJ, Sinton JE, Frazer DG, Morrison E. Therapeutic contact lenses and their use in the management of anterior segment pathology. J Br Contact Lens Assoc. 1996;19(1):11-9.



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About The Author

Maria Rumenova Boyadzhieva
Medical University of Varna

Department of Ophthalmology and Visual Sciences, Faculty of Medicine