Contact lens fitting following unsuccessful refractive surgery

Abstract

A retrospective review of case notes of consecutive patients referred to a contact lens clinic after unsuccessful refractive surgery was carried out to determine the success of contact lens fitting. The main outcome variables in determining success were visual improvement, contact lens tolerance, fitting characteristics and wearing time. Thirteen eyes were fitted with conventional rigid gas permeable (CRGP), 10 with soft and 19 with reverse geometry rigid gas permeable contact lenses (RVG). The mean spectacle visual acuity (VA) was 6/9 (20/30) [range: 6/24 (20/80) to 6/5 (20/15)] and the mean VA after contact lens fitting was 6/6 (20/20) [range: 6/18 (20/60) to 6/5 (20/15)]. Of the 42 eyes, the contact lens VA was better than spectacle acuity in 25 (59.5%) eyes, equal in 14 (33.3%) and worse in three (7.1%). A total of 33 (78.6%) eyes were still wearing their lenses at the last visit. Contact lenses can be a valuable method of managing poor VA after refractive surgery.

Scleral Lens Applications Focused on Korean Patients with Various Corneal Disorders

“…Eighteen eyes of 12 patients were fitted with scleral lenses due to their disability glare or monocular diplopia associated with irregular cornea astigmatism. In irregular astigmatism after refractive surgery, symptoms such as disability glare or diplopia may improve with scleral lenses [ 18 , 19 ]. In this study, most patients experienced improvements in these symptoms after wearing scleral lenses.…”

BCLA CLEAR – Medical use of contact lenses

“…Similar to the PK and LASIK/PRK fitting options above, the literature (mostly in the form of case series) documents a wide range of CL fitting options after radial keratotomy [558][559][560], which are considered more challenging to fit compared to nonsurgical eyes [561,562]. Soft lenses range from traditional daily disposable hydrogels [563] to conventional soft lenses [558,559]. Single case reports have described a high Dk lens compensating for diurnal fluctuations [556] or a prosthetic soft lens fitted after ruptured radial keratotomy incisions with iris damage [564].…”

“…Single case reports have described a high Dk lens compensating for diurnal fluctuations [556] or a prosthetic soft lens fitted after ruptured radial keratotomy incisions with iris damage [564]. Successful use of hybrid lenses has also been described in case series [559] Rigid corneal lens use includes reverse geometry lenses [490,558,565], which are often orthokeratology-designed lenses but used for daily wear to better match the post-radial keratotomy oblate contour [546,566,567], or plateau designs fitted soon after radial keratotomy to manipulate the healing process and influence the refractive results [568]. Traditional prolate designs have also been used extensively [525,559] with various fitting algorithms proposed.…”

Therapeutic Effects of Contact Lenses After Refractive Surgery

“…4 -16 Many of these reports have been small case studies, but several larger studies involving as many as 42 eyes have been published in the last several years. [13][14][15][16] Contact lenses provide a number of functions for eyes that have undergone refractive surgery, which include correction of residual ametropia, masking of surface corneal irregularities such as striae, central islands, and small or decentered ablations. Soft lenses can act as bandage lenses for the protection of the cornea from exposure in severe dry eye and to facilitate reepithelialization of the cornea after surface ablation procedures and after recurrent corneal erosions.…”