1 Arquivos Brasileiros de Oftalmologia 2005 Vol: 68(1):. DOI: 10.1590/S0004-27492005000100017

Adaptação de lentes de contato após cirurgia refrativa

PURPOSE: To evaluate the fitting and use of contact lens in patients submitted to refractive surgery. METHODS: This was a retrospective study in 53 patients submitted to refractive surgery who later started to use contact lens, from 1999 to 2003. The parameters were: previous ametropia, refractive surgery procedure, ametropia after surgery, postoperative spherical equivalent, postoperative keratometry, base curve of fitted contact lens, contact lens design, final visual acuity with spectacles after surgery, final visual acuity with contact lens, complications and the reason for stopping the use. The follow-up of patients ranged from 1 month to 84 months (average of 42,5 months). RESULTS: Of 53 evaluated patients, 19 patients had undergone LASIK (Laser Assisted in Situ Keratomileusis), 29 patients had undergone RK (radial keratotomy), 4 patients had undergone PRK (photorefractive keratectomy) and in one patient it was not possible to know which surgery was performed. 61.29% of the patients (57 eyes of a total of 93 eyes) were fitted with rigid gas-permeable lenses. There was an improvement of visual acuity in 60.21% of the cases (VA>20/40), with few complications. CONCLUSION: Due to the great number of performed refractive surgery, an increase in the number of patients unhappy with the postoperative result is expected, and for these patients, many times the use of contact lens is the best option. The fitting of contact lenses after refractive surgery demands knowledge, dedication and has good results principally regarding better visual acuity.

  1. Yeung KK, Olson MD, Weissman BA. Complexity of contact lens fitting after refractive surgery. Am J Ophthalmol.133(5) , 607-12 (2002) .
  2. Shivitz IA, Arrowsmith PN, Russel BM. Contact lenses in the treatment of patients with overcorrected radial keratotomy. Ophthalmology.94(8) , 899-903 (1987) .
  3. Eggink FA, Beekhuis WH, Nuijts RM. Rigid gas-permeable contact lens fitting in LASIK patients for the correction of multifocal corneas. Graefes Arch Clin Exp Ophthalmol.239(5) , 361-6 (2001) .
  4. Rowsey JJ, Rubin ML. Refraction problems after refractive surgery. Surv Ophthalmol.32(6) , 414-20 (1988) .
  5. Astin CL, Gartry DS, McG Steele AD. Contact lens fitting after photorefractive keratectomy. Br J Ophthalmol.80(7) , 597-603 (1996) .
  6. Davis LJ. Rigid gas permeable extended wear (RGPEW) for the postoperative patient: a review and clinical observations. J Am Optom Assoc.65(3): .Review , 179-86 (1994) .
  7. Alio JL, Belda JI, Artola A, Garcia-Lledó M, Osman A. Contact lens fitting to correct irregular astigmatism after corneal refractive surgery. J Cataract Refract Surg.28(10) , 1750-7 (2002) .
  8. Eggink FA, Beekhuis WH. Contact lens fitting in a patient with keratectasia after laser in situ keratomileusis. J Cataract Refract Surg.27(7) , 1119-23 (2001) .
  9. Astin CL. Contact lens fitting after photorefractive keratectomy: a comparison of two groups of patients. Ophthalmic Physiol Opt.15(5) , 371-4 (1995) .
  10. Bourque LB, Lynn MJ, Waring GO 3rd, Cartwright C. Spectacle and contact lens wearing six years after radial keratectomy in the prospective evaluation of radial keratectomy study. Ophthalmology.101(3) , 421-31 (1994) .
  11. McDonnell PJ, Garbus JJ, Caroline P, Yoshinaga PD. Computerized analysis of corneal topography as an aid in fitting contact lenses after radial keratotomy. Ophthalmic Surg.23(1) , 55-9 (1992) .
  12. Hersh PS, Ratnakaram R, Hersh D, Fry K. Diagnostic use of a rigid contact lens to show corneal topography abnormalities after laser refractive surgery. J Cataract Refract Surg.28(11) , 2054-7 (2002) .
  13. Lim L, Siow KL, Chong JS, Tan DT. Contact lens wear after photorefractive keratectomy: comparison between rigid gas permeable and soft contact lenses. CLAO J.25(4) , 222-7 (1999) .
  14. Lim L, Siow KL, Sakamoto R, Chong JS, Tan DT. Reverse geometry contact lens wear after photorefractive keratectomy, radial keratectomy, or penetrating keratoplasty. Cornea.19(3) , 320-4 (2000) .