Corneoscleral contact lenses fitting on irregular corneas after laser-assisted in situ keratomileusis

Arq Bras Oftalmol. 2018 Jul-Aug;81(4):310-315. doi: 10.5935/0004-2749.20180061.

Abstract

Purpose: We aimed to describe the outcomes of corneoscleral contact lens fitting with multi-aspherical geometry designs in patients with irregular corneas after laser-assisted in situ keratomileusis (LASIK).

Methods: This was a retrospective series of 18 patients (age, 26-38 years) selected from an eye clinic database. Participants were required to have unsatisfactory visual acuity with their current contact lenses or spectacles after LASIK for myopia correction. All patients were fitted with corneoscleral contact lenses designed to correct corneal surface irregularities. A diagnostic trial set was used for fitting, and assessments were performed according to a standardized methodology. Subjective comfort, visual acuity, central corneal thickness, endothelial cell count, and corneal-compensated intraocular pressure were evaluated. The follow-up period was one year.

Results: Contact lens use was discontinued in 3 patients, thus leaving 24 eyes from 8 females and 7 males for analysis. The fitting characteristics were optimal in terms of lens position and movement. Statistically significant improvements were found in the best spectacle-corrected vision from before fitting to the visual acuity after fitting (p<0.001). Moreover, the patients reported high subjective comfort ratings and usage times (12.98 ± 2.3 hours/day). After one year of wear, visual acuity, subjective comfort, and usage time were maintained. No statistically significant adverse changes developed in the corneas over this period.

Conclusion: Corneoscleral contact lenses with a multi-aspherical geometry design provide optimal visual acuity, improved comfort, and prolonged usage times in patients with irregular corneas after LASIK.

MeSH terms

  • Adult
  • Contact Lenses, Hydrophilic*
  • Corneal Pachymetry
  • Corneal Topography
  • Corneal Wavefront Aberration / etiology*
  • Corneal Wavefront Aberration / rehabilitation
  • Follow-Up Studies
  • Humans
  • Keratomileusis, Laser In Situ / adverse effects*
  • Myopia / surgery*
  • Retrospective Studies
  • Visual Acuity