Contact lenses following corneal refractive eye surgery (such as Lasik, Lasek, PRK, or RK) can provide excellent visual correction. But often specialist contact lenses are required to provide good fitting and comfort.
We are frequently contacted by patients who have previously undergone corneal refractive procedures such as laser eye surgery and find themselves requiring visual correction again in later life. Many have tried standard contact lenses without success.
Why Don’t Standard Contact Lenses Work Very well following Corneal Refractive Surgery?
Refractive eye surgery to reduce myopia, works by flattening the central cornea. Laser surgery (Lasik, Lasek or PRK) flattens the cornea by re-sculpting the front surface of the eye, whereas surgical procedures such as radial keratotomy achieve central corneal flattening by making small incisions around the centre.
Usually contact lenses are steepest in the centre, flattening towards the edge, to align with normal healthy eyes and therefore do not fit very well following corneal refractive surgery, where the eye has been flattened centrally.
Fortunately, our contact lens specialists in London, have several solutions which can provide clear, comfortable vision following laser eye surgery.
Contact lens options following Corneal Refractive Eye Surgery:
- Soft Contact Lenses following refractive eye surgery
Although most standard soft contact lenses do not fit very well following laser eye surgery, there are a few very thin and flat disposable soft lenses which drape over the front surface of the eye providing adequate visual correction. Disposable soft contact lenses can provide a good option for sports and social wear and are sometimes the cheapest and simplest solution, but unfortunately they don’t work for everyone.
- Large RGP Contact Lenses made in a reverse geometry shape
Rigid Gas Permeable (RGP) contact lenses provide excellent vision and are very durable, usually lasting at least one year. However standard shape RGP contact lenses that align with the central cornea will be too flat around the edge and move excessively, whereas steeper lenses can cause problems with flexure and binding. Reverse geometry designs, address both of the issues, and can be made in large diameters to give a stable fit with excellent vision. They do however require persistence and adaptation especially in the early stages of wear.
- Hybrid Contact Lenses following refractive eye surgery
Hybrid contact lenses have a rigid centre with a soft skirt. These contact lenses combine the benefits of excellent vision provided by a rigid contact lens with the improved comfort of soft contact lenses. Special flat curve designs are usually required following laser eye surgery as the standard shapes are likely to be too steep centrally and cause problems further down the line. Hybrid contact lenses should be replaced every 6 months.
- Scleral Contact Lenses following refractive eye surgery
Scleral contact lenses are large diameter rigid lenses which vault over the front of the eye, providing a new refractive surface. They are usually very comfortable because they do not touch the cornea and do not move around like smaller contact lenses. They are also very durable and should last at least one year if maintained correctly.
All of the above options have advantages and disadvantages. The prospects for success, with each kind of contact lens depends largely on the shape of the anterior ocular surface (corneal topography), the health of the eyes and how dry they are. Larger diameter scleral and hybrid contact lenses often settle back on to the eye, requiring several appointments to monitor the fit and if necessary, tweak the prescriptions.