Objective evaluation of the visual benefit in contact lens fitting after complicated LASIK.

Purpose: To report the clinical application of the measurement of luminous distortion under scotopic conditions and wavefront aberrations to objectively corroborate the optical and visual benefit of contact lens fitting to rehabilitate vision after complicated LASIK.

Methods: Seven eyes (four patients) that underwent LASIK for the correction of myopia with different postoperative visual complaints are reported in this observational case series. Luminous distortion index with the Starlights System v1.0 (Novosalud) and total wavefront aberration using a Hartmann-Shack aberrometer were used to objectively quantify the benefit of contact lens fitting to corroborate subjective improvements in terms of patient satisfaction and photopic visual acuity. Uncorrected visual acuity, best spectacle and contact lens corrected visual acuity, root-mean-square for higher order aberrations, and luminous distortion under scotopic conditions were obtained.

Results: Visual complaints were attributed to a small optical zone, decentered ablation, and iatrogenic ectasia, and patients were fit with contact lenses of different materials, designs, and fitting approaches. Reverse geometry rigid gas permeable contact lenses are beneficial in reducing higher order aberrations to less than one half of the cornea and total aberrometry, with a positive effect in reducing luminous distortion up to 100% associated with complaints of night vision distortion to less than 5% in patients with small optical zones or decentered ablations. Artificial pupil cosmetic soft contact lens also decreased the luminous distortion index.

Conclusions: The visual benefit reported by patients after contact lens fitting in postoperative complications secondary to LASIK can be objectively measured through the luminous distortion under scotopic conditions.