Rigid Gas Permeable Contact Lens Use as a Risk Factor for LASIK Retreatment

Abstract

 

Purpose:

 

To compare the retreatment rate after primary LASIK for myopia, hyperopia, or astigmatism of patients with hard contact lens use to that of patients with soft, toric, or no contact lens use.

 

Methods:

 

This is a retrospective cohort study of all patients undergoing primary LASIK at the University of California San Francisco from 1999–2002. The records were reviewed for history of hard, toric, or soft contact lens use within 6 months of exam, patient’s age, surgeon, manifest refraction spherical equivalent, corneal curvatures by Atlas corneal topographer, corneal thickness by DGH ultrasound pachymetry, surgeon, and if a retreatment was performed within 1 year of the primary procedure. We performed logistic regression predicting retreatment using hard contact lens use, age, pre–treatment spherical equivalent, central corneal thickness, topographic astigmatism, and surgeon as covariates, and adjusting for correlation between eyes (Huber–White Sandwich estimator, Stata 7.0).

 

Results:

 

A total of 1409 eyes were studied, of which 173 eyes (12.3%) were in patients with a history of rigid gas permeable contact lens use. 1383(98%) eyes had myopic LASIK performed while only 26 eyes (2%) had hyperopic LASIK performed. Patients with a history of hard contact lens use had a statistically significant difference in the rate of retreatment compared to patients with a history of soft, toric, or no contact lens use (Table 1). In addition older age, a higher pre–operative spherical equivalent, and surgeon also were statistically significant risk factors. The amount of topographic astigmatism and central corneal thickness were not statistically significant factors.  

 

Conclusions:

 

Patients with a history of hard contact lens use have a statistically higher rate of retreatment after primary LASIK. This risk is statistically independent of other possible confounding risk factors including patient's age, refractive error, central corneal thickness, amount of astigmatism, and surgeon.

 

Keywords: refractive surgery: LASIK • refractive surgery: comparative studies