CONTACT-LENS FITTING AFTER PHOTOREFRACTIVE KERATECTOMY

Aims/background-This study evaluated contact lens fitting and the long er term response of the photorefractive keratectomy (PRK) cornea to le ns wear. In PRK for myopia problems such as regression, anterior strom al haze, irregular astigmatism, halo aberration, and anisometropia hav e been reported. Certain patients therefore require contact lens corre ction to obtain best corrected visual acuity (BCVA). Method-From an or iginal cohort of 80 patients, 15 were dissatisfied with their visual o utcome 6 months after PRK. Ten of these were fitted with lenses and mo nitored regularly. Results-The best fit rigid gas permeable lens of di ameter 9.20-10.00 nun was generally 0.10 mm steeper than mean keratome try readings. Because of lid discomfort five patients were refitted wi th daily wear soft lenses. All 10 achieved satisfactory lens wear of 1 0 hours per day. Central corneal steepening of 0.75 D (0.15 mm) occurr ed in one patient. Two patients had slight central corneal flattening. Three patients discontinued lens wear as they found lens care a nuisa nce. Four finally opted for retreatment by PRK. Conclusions-In most ca ses, contact lenses gave good visual acuity and, in cases of mild irre gular astigmatism, a significant improvement over spectacle BCVA. No s ignificant adverse reaction to contact lens wear was found. Although o cular tolerance of lenses was satisfactory, several patients discontin ued lens wear or sought improved unaided vision.