LASIK (Laser-Assisted In Situ Keratomileusis) is a surgical procedure that uses a laser to reshape the cornea, correcting refractive errors like nearsightedness, farsightedness, and astigmatism. The goal is to eliminate the need for external vision correction. While the goal is permanent visual freedom, wearing contact lenses afterward is possible and sometimes required, though the circumstances are highly conditional.
Immediate Post-Surgery Restrictions
Directly following LASIK, patients must strictly avoid wearing contact lenses for a significant period. This restriction protects the delicate corneal tissue and the surgically created flap. The flap must adhere securely, and the surface layer must fully heal to ensure a smooth, intact surface. Introducing a contact lens too soon interferes with this natural healing process, disrupting recovery and significantly elevating the risk of post-operative infection. Eye care professionals typically require patients to wait at least a few weeks to several months, often 2 to 3 months, allowing the cornea to stabilize and the refractive results to become final.
Addressing Residual Vision Issues
Months or years post-surgery, a patient might need contact lenses due to various clinical situations. One common reason is a residual refractive error, occurring when the LASIK treatment results in a slight undercorrection or overcorrection. A contact lens can fine-tune this minor remaining prescription for optimal visual clarity.
Another frequent scenario is the onset of presbyopia, the age-related loss of near focusing ability that typically begins around age 40. Since LASIK corrects distance vision, it does not prevent this natural aging process. Patients may use multifocal or monovision contact lenses to regain clear vision for reading and close-up tasks.
In rarer instances, contacts manage complications like corneal ectasia or significant irregular astigmatism. These conditions cause severe visual distortion that cannot be corrected with glasses alone. Specialized therapeutic contact lenses are used to create a smooth optical surface over the irregular cornea.
Specialized Fitting Needs Post-LASIK
The primary challenge in fitting contact lenses after LASIK stems from the altered corneal geometry. A normal cornea is prolate, meaning it is steepest in the center and gradually flattens toward the periphery. The LASIK procedure, however, flattens the central treatment zone, changing the shape to an oblate profile. This oblate shape means that a standard soft contact lens, designed for prolate corneas, will often fit poorly.
Such a lens may decenter, causing unstable vision, or create areas of excessive pressure on the altered corneal surface. The unique post-LASIK shape requires a specialized fitting process that often begins with advanced imaging like corneal topography. Specialty lenses are often the best solution for the surgically modified eye.
Rigid Gas Permeable (RGP) lenses, particularly those with a reverse geometry design, are used to conform to the flatter central cornea. For patients with significant irregularity or chronic dry eye, Scleral lenses are frequently preferred. Scleral lenses are large-diameter RGP lenses that completely vault over the cornea and rest entirely on the sclera.
By bridging the corneal surface, these lenses neutralize visual distortions and create a fluid-filled reservoir between the lens and the cornea. This reservoir provides continuous moisture, which is particularly beneficial for post-LASIK patients who often experience chronic dry eye symptoms.