Contact lens fitting after photorefractive keratectomy

Area of Science:

• Ophthalmology
• Corneal Surgery
• Optometry

Background:

• Photorefractive keratectomy (PRK) for myopia can lead to visual complications like regression, haze, and irregular astigmatism.
• Some patients require contact lens correction to achieve optimal visual outcomes post-PRK.
• Best corrected visual acuity (BCVA) may be suboptimal for certain individuals after PRK.

Purpose of the Study:

• To evaluate contact lens fitting in patients who underwent PRK.
• To assess the long-term response of the PRK cornea to contact lens wear.
• To determine the efficacy of contact lenses in improving visual acuity in post-PRK patients.

Main Methods:

• A cohort of 80 patients was initially assessed 6 months post-PRK.
• Fifteen patients dissatisfied with visual outcomes were identified.
• Ten of these patients were fitted with contact lenses (rigid gas permeable or soft) and monitored.

Main Results:

• Rigid gas permeable lenses, 9.20-10.00 mm in diameter, were typically fitted 0.10 mm steeper than mean keratometry.
• Five patients switched to daily wear soft lenses due to lid discomfort, achieving 10 hours of wear daily.
• Minor corneal changes (steepening/flattening) occurred in 3 patients; 3 discontinued lens wear, and 4 opted for retreatment.

Conclusions:

• Contact lenses generally provided good visual acuity and improved BCVA in cases of mild irregular astigmatism post-PRK.
• No significant adverse reactions to contact lens wear were observed.
• Despite satisfactory ocular tolerance, some patients discontinued lens wear or sought further surgical correction.