Post-LASIK Visual Quality With a Corneoscleral Contact Lens to Treat Irregular Corneas

Abstract

Objective: To evaluate the visual quality results of fitting a corneoscleral contact lens with multiaspheric geometry design (MAGD CScL) in subjects with irregular corneas after laser-assisted in situ keratomileusis (LASIK) surgery. Methods: From a database of patients evaluated for scleral contact lenses, we identified those with irregular corneas and visual problems after they underwent LASIK surgery for correcting myopia. They manifested unsatisfactory visual quality with their current contact lenses or glasses. Therefore, a MAGD CScL was fitted and monitored according to standardized fitting methodology. A diagnostic trial set was used in the fitting process. Visual acuity (VA), subjective visual quality (SVQ), and ocular aberrations were evaluated. A new re-evaluation of these parameters was performed after 1 year wearing MAGD CScL. Results: Eighteen eyes of 18 patients (10 male and 8 female) with irregular cornea after LASIK surgery participated in this study; their ages ranged from 27 to 39 years (mean±SD, 32.6±3.8 years). All patients showed good fitting characteristics: optimal values were seen for lens position and lens movement. Statistically significant differences were found between before and after fitting MAGD CScL in the VA (mean±SD, 0.14±0.03 logMAR and 0.01±0.06 logMAR, respectively; P<0.001); ocular aberrations of second-order, coma, spherical; and the total higher-order aberrations (HOAs) (all P<0.001). The total HOAs decreased by approximately 78% to normal levels after fitting MAGD CScL. In addition, SVQ was also significantly improved after fitting MAGD CScL (16 eyes were favorable or very favorable). After 1 year wearing MAGD CScL, no statistically significant differences were found in the total HOAs and VA in regard to the initial fitting. Conclusions: Corneoscleral contact lens with multiaspheric geometry design is proposed as an effective procedure, providing a good VA and an optimal visual quality on irregular corneas after LASIK surgery in myopic subjects.