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To investigate the influence of previous soft contact lens (SCL) wear on outcomes of corneal refractive surgery (CRS). SCL wear can reduce accuracy of pre-operative corneal measurements and outcomes of CRS. Short SCL cessation times prior to CRS may be insufficient for resolution of SCL-induced corneal changes. It was hypothesised that the visual and refractive CRS outcomes would be worse in a SCL group compared to a non-contact lens (NCL) group and worse in a SCL group who ceased SCL wear for 24 hours when compared to those who ceased SCL wear for two weeks prior to examination and treatment.
CRS outcomes for dominant eyes of two groups of previous full-time SCL wearing patients were analysed retrospectively; those who ceased SCL wear for two weeks (n = 45) and twenty four hours (n = 49) prior to examination and treatment. In both groups results were compared to a NCL control group (2 weeks NCL group n = 45; 24 hours NCL group n = 49). LASIK and PRK/LASEK one, three and six months post-operative outcomes were assessed for efficacy (unaided distance visual acuity (UDVA) and residual refractive error), predictability (number of eyes within ± 0.25D and ± 0.50D of desired refractive outcome) and safety.
There was a trend towards superior CRS outcomes for efficacy, predictability and safety in the two weeks SCL cessation group compared to NCL group. These results were significantly better for LogMAR UDVA in the SCL group and were maintained to the six month post-operative visit (LASIK SCL: -0.10 ± 0.10, NCL: -0.06 ± 0.07, p = 0.03; LASEK/PRK SCL: -0.10 ± 0.08, NCL -0.04 ± 0.08, p = 0.03).
These findings were reiterated in the 24 hours SCL cessation group where the trend towards superior CRS outcomes for efficacy, predictability and safety in the SCL group compared to the NCL group was continued. UDVA efficacy outcomes following LASEK/PRK were significantly better in the SCL group at the six month post-operative visit (SCL: -0.11 ± 0.03, NCL -0.04 ± 0.07, p = 0.03).
Previous SCL wear did not negatively impact on CRS outcomes. SCL cessation times of two weeks and twenty four hours did not result in negative outcomes compared to a NCL control group. While these results were statistically significant, the number of letters difference in UDVA between the SCL and NCL groups was low and so one cannot conclude that these results are clinically significant.
Lloyd McKernan, A, Simo Mannion, L. & O’Dwyer V. (2015) The effect of two weeks and twenty-four hours soft contact lens cessation times on corneal refractive surgery outcomes. Poster presentation, European Academy of Optometry. Budapest, May 2015.