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R.M. Davis; A New Therapeutic Application of Omafilcon a After Laser–Assisted Subepithelial Keratomileusis (LASEK) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4343.
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Purpose: Therapeutic contact lens wear following LASEK may affect patient outcomes in the early postoperative period. Little attention has been given to the role of postoperative contact lens wear with respect to wound healing. A contact lens constituted with a lipid hydrogel polymer was evaluated as a continuous therapeutic lens after LASEK. Methods: We performed a retrospective analysis of 78 consecutive eyes (40 patients) that underwent LASEK in a one–year period. Eligibility included patients with insufficient residual depth and or a pre–existing diagnosis of dry eye syndrome. The epithelium was scored with a 9.0 mm serrated trephine followed by a 50 second application of 20% alcohol in a 9.5 mm trephine well. The epithelium was lifted followed by laser ablation with the Bausch and Lomb Technolas 317 excimer laser. Following laser treatment, the epithelium was repositioned, a topical steroid and a broad–spectrum antibiotic were applied four times per day for one week. All patients were fitted with omafilcon A (Proclear, Coopervision) immediately following surgery. Patient records were reviewed for lens movement, wound healing characteristics, and complications related to the therapeutic contact lens. Results: The mean preoperative sphere was –8.32 + 1.86 D. The mean cylinder was +1.72 + 1.20 D. At one week, 76% (49/78) and 18% (14/78) were better than 20/40 and 20/20. All patients tolerated omafilcon A without complications resulting in discontinuation of the lens. Lens movement was acceptable in all cases by physician report. Wound healing assessment the first day after surgery revealed microcystic edema apparent at the LASEK wound interface and normal appearing central epithelium in the majority of cases. Continuous contact lens wear for 1–7 days was observed in most cases. The most common patient complaint attributed to the lens was a foreign body sensation. Conclusions: Therapeutic contact lens wear with omafilcon A after LASEK was well tolerated facilitating normal wound healing without complications. This may be due to greater tear film and lens stability, which may in part be related to the specific lipid hydrogel characteristics of the contact lens. Extended wear of omafilcon A is an off–label application.
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