Varieties of contact lens fittings after complicated hyperopic and myopic laser in situ keratomileusis.

Purpose: To determine whether contact lenses with a special back surface design can improve visual acuity after complicated laser in situ keratomileusis (LASIK).

Methods: Fifteen eyes (six after myopic LASIK and nine after hyperopic LASIK) of eight patients were fitted with contact lenses with a special back surface design for optical rehabilitation. Four different types of lenses (aspheric, tricurve, keratoconus, and reverse) were used selectively, depending on the abnormal eccentricity (positive and exceeding 0.5-0.7 in all preoperatively hyperopic eyes, negative in all preoperatively myopic eyes) determined by videokeratoscope and on individual conditions. The patients were followed up retrospectively for an average period of 12.3 months. Lens tolerance and corrected visual acuity were evaluated and compared with the results obtained with spectacles.

Results: Visual acuity improved in nine (60%) of 15 eyes (three eyes by more than three lines and six eyes by three lines or fewer), with an absence of halos and ghost images in four (26.7%) of 15 eyes accompanied by good contact lens tolerance and a satisfactory contact lens fit. There were no noticeable complications.

Conclusions: Contact lens fitting after LASIK is a safe and reliable procedure for improving visual acuity and reducing complications, such as ghost images or irregular corneal surface. Depending on the eccentricity and therefore on the preoperative refraction, contact lenses with a special back surface design can minimize problems in contact lens fitting and can improve tolerance and visual results.