Contact lens fitting to correct irregular astigmatism after corneal refractive surgery

To study a technique of contact lens fitting and its visual results in patients with irregular astigmatism induced by corneal refractive surgery.

Department of Cornea and Refractive Surgery, Instituto Oftalmológico de Alicante, Alicante, Spain.

This prospective noncomparative study comprised 29 eyes with irregular astigmatism after corneal refractive surgery. Different types of contact lenses were used to correct the astigmatism: hard, gas permeable, hybrid, and toric hydrophilic. Preoperative and postoperative data were analyzed for proper fitting including the preoperative keratometeric reading and corneal ablation zone.

Proper contact lens fitting was achieved in 23 eyes (79.3%). In 6 eyes (20.7%), fitting was not possible despite an improvement in best corrected visual acuity (BCVA). Of the eyes with proper fitting, 14 (60.9%) had rigid gas-permeable lenses (9.80 mm), 6 (26.1%) had hydrophilic lenses (14.00 mm), and 3 (13.0%) had hybrid lenses (14.3 mm). Comparing the BCVA with that with spectacles, 23 eyes (79.3%) gained 2 lines or more of BCVA, 4 (13.8%) gained 1 line, and 2 (6.9%) maintained the same acuity as with spectacles. No eye lost lines of BCVA.

Results indicate that contact lens fitting is a good-and sometimes the only-alternative for patients with induced irregular astigmatism. Rigid gas-permeable contact lenses provided the best visual performance and patient tolerance.