Contact lens fitting difficulties following refractive surgery for high myopia.
OBJECTIVE
To describe the clinical and optical problems encountered in contact lens fitting following refractive surgery for high myopia.


METHODS
Following refractive surgery for high myopia (greater than -10.00 D) we corrected residual refractive errors with contact lenses in the four eyes of two patients. The first patient had undergone bilateral laser in situ keratomileusis (LASIK),with two subsequent LASIK retreatments in the left eye. Ten months later she was fit with rigid gas permeable (RGP) lenses in both eyes. The second patient had undergone a clear lens extraction in the right eye and radial keratotomy followed by photorefractive keratectomy(PRK) in the left eye. She was fit with toric soft lenses six years postoperatively.


RESULTS
Final visual acuity obtained with contact lenses was 20/25-20/20 in all eyes. The first patient required significant minus lens power compensation. Furthermore, the RGP lens in the left eye was slightly decentered due to corneal irregularity induced by LASIK. The second patient had regular corneal surfaces and was successfully fit with daily wear toric soft lenses despite the 2.75 D of residual astigmatism in the left eye.


CONCLUSIONS
Following refractive surgery for high myopia a proportion of patients will remain undercorrected. In these patients the alterations in corneal architecture that ensue make contact lens fitting more challenging. Patients with regular astigmatism may be fitted successfully with toric soft lenses. Patients with corneal irregularities should be fit with RGP lenses.
Bufidis
T
T
Ophthalmologic Center of Northern Greece, Thessaloniki.
Konstas
A G
AG
Pallikaris
I G
IG
Siganos
D S
DS
Georgiadis
N
N
D000328:Adult; D003263:Contact Lenses, Hydrophilic; D019781:Corneal Topography; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D007646:Keratotomy, Radial / Q000009:adverse effects*; D054018:Lasers, Excimer; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000628:therapy*; D017755:Prosthesis Fitting; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000628:therapy; D014792:Visual Acuity