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U. Kloevekorn–Fischer, K. Kloevekorn–Norgall, G.I. W. Duncker, C. Gruenauer–Kloevekorn; Options And Limits of Visual Rehabilitation Using Contact Lenses in Patients After Complicated Laser in situ Keratomileusis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2075.
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Purpose: Certain changes in the anterior corneal surface and especially in the eccentricity can be found in eyes following LASIK making the fitting of contact lenses difficult. In our study we try to determine which special back surface design should be used in which case and whether fitting of contact lenses could improve the visual acuity in complicated post LASIK cases. Methods: The choice of the contact lens design depending on the corneal eccentricity was analysed in 12 eyes of six patients who had undergone contact lens fitting following complicated LASIK. Results: In all cases we chose the back surface of the initial lens depending on the measured eccentricity. Using this strategy we managed to get optimal contact lens fit in 8 out of 12 cases (67%). In 2 cases with negative eccentricity we had to change the back surface design from reverse to aspheric with a good result. Although in 4 cases eccentricity was bigger than 0.7 we could fit an aspheric design. In 10 of 12 cases (83.3%) contact lens fitting was successful with regard to an improvement of the visual acuitiy, loss of ghost images or correcting residual refractive error. In two cases there was no improvement of visual acuity because of a central haze. Conclusions: Contact lens fitting after LASIK is a safe and reliable procedure to improve visual acuity and reduce complications such as ghost images or irregular astigmatism. Fitting of rigid gas permeable contact lenses and the choice of a special back surface design depending on the measured eccentricity minimize problems in contact lens fitting after LASIK and can improve the tolerance and the visual results.
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