Therapeutic effects of contact lenses after refractive surgery.
OBJECTIVE
Although highly successful, refractive surgery can have adverse effects, such as loss of best spectacle-corrected visual acuity, glare, haloes, monocular polyopia, and loss of contrast. Further surgical intervention may no longer be an adequate or appropriate response. The efficacy of rigid gas-permeable contact lenses and their therapeutic effects in managing these conditions are studied.


METHODS
A retrospective review of the records of 67 eyes of 37 patients fitted with contact lenses after different refractive surgeries was performed. The most successful lens design for each patient was evaluated. Klyce corneal statistics of surface regularity index and surface asymmetry index, mean keratometric values, and optical zone diameter were measured before and after contact lens wear using the Tomey TMS-2 topographer. Comparative wavefront aberrometry was obtained for five eyes of three patients.


RESULTS
The cohort had a mean uncorrected visual acuity of 20/40, a mean best spectacle-corrected visual acuity of 20/26, and a mean visual acuity with contact lenses of 20/20. Contact lens wear resulted in significant improvements in corneal regularity and symmetry, as indicated by Klyce corneal statistics, with concomitant improvements in visual acuity between wearing periods. The mean visual acuity on lens removal was 20/24. This lens molding effect lasted from several hours to several days. The lenses also had the effects of decreasing higher-order aberrations, as measured by wavefront aberrometry in three patients.


CONCLUSIONS
Rigid gas-permeable contact lenses can dramatically improve visual acuity and higher-order aberrations in eyes of patients with unsatisfactory refractive surgery outcomes. Contact lenses can also have a measurable therapeutic effect on vision when the lenses are not being worn or cannot be worn full time.
Gemoules
Greg
G
greggem@ix.netcom.com
D000328:Adult; D003261:Contact Lenses; D019781:Corneal Topography; D004867:Equipment Design; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000628:therapy; D020731:Keratomileusis, Laser In Situ; D007646:Keratotomy, Radial; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000628:therapy; D018903:Photorefractive Keratectomy; D012030:Refractive Errors / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D054140:Refractive Surgical Procedures; D012189:Retrospective Studies; D014792:Visual Acuity