Abstract
Abstract: :
Purpose: To evaluate the resolution of contact lens-induced corneal warpage prior to photorefractive surgery Methods: We studied the eyes of 165 consecutive contact lens-wearing patients sheduled for photorefractive surgery. Significant contact lens-induced corneal warpage was detected by corneal topography in 20 eyes of 11 patients. Manifest refraction, keratometry and corneal topography were subsequently recorded during weekly or biweekly re-evaluations. Age, sex,type and duration of contact lens wear and the recovery time period to stabilization were analyzed. Results: There was a 12% incidence of significant contact lens-induced corneal warpage. The mean duration of prior contact lens wear was 21.2 years (range 10 to 30 years). Lens types included daily wear soft (n=2), extended wear soft (n=6), toric (n=4), and regid gas permeable contact lenses (n=8). Up to 3.0D refractive and 2.5D keratometry changes accompanied by significant topography pattern differences were observed. The average recovery time for stablization of refraction, keratometry (change within+/-0.5D) and topography pattern was 7.8+/-8.5 weeks (range 1 to 20 weeks). Recovery rates differed between the lens types: soft extended wear 11.6+/-8.5 weeks, soft toric lens 5.5+/-4.9 weeks, soft daily wear 2.5+/-2.1 weeks and gas permeable 8.8+/-6.8 weeks. Conclusion: We observed a 12% incidence of signifcant contact lens-induced corneal warpage. It occurs with all types of contact lens wear, but resolves at different rates. To optimiz the quality and predictability of photorefractive procedures, an appropriate waiting period is necessary for contact lens-induced corneal warpage to stabilize. We suggest that resolution of corneal warpage is documented by stable serial manifested refraction, keratometry and corneal topographic pattern.
Keywords: 367 contact lens • 369 cornea: clinical science • 544 refractive surgery