title: Contact lens assisted pharmacologically induced keratoshaping.
abstract: OBJECTIVE
  To retrospectively evaluate the effectiveness and describe the process of reducing hyperopia with a nonsteroidal antiinflammatory agent and a soft disposable contact lens in postoperative excimer laser patients with consecutive hyperopia.
  
  
  METHODS
  Private practice.
  
  
  METHODS
  This study includes a retrospective analysis of 14 eyes of 12 patients who underwent laser in situ keratomileusis or photorefractive keratectomy and experienced consecutive hyperopia. Patients were treated with a tightly fit, extended-wear contact lens in combination with the use of ketorolac tromethamine 0.5% (Acular) in an attempt to steepen the cornea. Uncorrected visual acuity, manifest refraction, and slitlamp examination were performed on a weekly basis until the desired outcome was achieved or until treatment was discontinued.
  
  
  RESULTS
  A total of 78.57% of eyes experienced a decrease in consecutive hyperopia (>or=0.50 diopters [D]) (P = 0.002). The mean dioptric change was 1.05D. A total of 88.89% of eyes experienced an increase in uncorrected visual acuity (>or=1 line) (P < 0.001). The mean increase was three lines of Snellen or Jaeger acuity. The mean number of weeks to see an effect was 1.71 weeks, and the mean number of weeks to achieve endpoint was 8.29 weeks (median, 6 weeks). CONCLUSIONS.: Contact lens-assisted pharmacologically induced keratoshaping is an effective treatment option for patients who experience consecutive hyperopia after laser in situ keratomileusis or photorefractive keratectomy.
authors.affiliation: McDonald Eye Associates, 3318 North Hills Boulevard, Fayetteville, AR 72701, USA. mcdonaldje@mcdonaldeye.com
authors.forename: James E
authors.initials: JE
authors.lastname: McDonald
authors.forename: Allyson
authors.initials: A
authors.lastname: Mertins
authors.forename: David
authors.initials: D
authors.lastname: Deitz
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003262:Contact Lenses, Extended-Wear; D003315:Cornea / Q000503:physiopathology; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects; D020911:Ketorolac Tromethamine / Q000627:therapeutic use*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000009:adverse effects; D012189:Retrospective Studies; D014792:Visual Acuity
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D020911:Ketorolac Tromethamine