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Home > Archive > Lasik Eyes Surgery > December 2004 > New Study Says Discontinue Lens Wear 6 Weeks Before LASIK
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| Author |
New Study Says Discontinue Lens Wear 6 Weeks Before LASIK
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| doctor_my_eye@msn.com 2004-12-20, 7:17 pm |
| An article in Journal of Cataract and Refractive Surgery in the Nov 30
issue advises that gas permeable contact lens wearers wait 6 weeks
before LASIK, instead of the 3 weeks commonly thought.
The authors found that 44% of refractions on lens-wearing eyes were
still unstable at 3 weeks.
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| Glenn - USAEyes.org 2004-12-20, 7:17 pm |
| Our organization is a little more conservative on this issue, and we
break it down to type of contact lens, be it soft, soft toric, rigid
gas permeable (RGP), and based upon length of time of wear. See
http://www.usaeyes.org/faq/subjects/contacts.htm for details.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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| Dr. Leukoma 2004-12-20, 10:08 pm |
| Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in
news:61oes0t1skeiibil17ddr940cn605v0dq9@4ax.com:
> Our organization is a little more conservative on this issue, and we
> break it down to type of contact lens, be it soft, soft toric, rigid
> gas permeable (RGP), and based upon length of time of wear. See
> http://www.usaeyes.org/faq/subjects/contacts.htm for details.
>
> Glenn Hagele
> Executive Director
> Council for Refractive Surgery Quality Assurance
>
> Email to glenn dot hagele at usaeyes dot org
>
> http://www.USAEyes.org
> http://www.ComplicatedEyes.org
>
> I am not a doctor.
>
Time to Resolution of Contact Lens-Induced Corneal Warpage Prior to
Refractive Surgery. CLAO Journal. 28(4):169-171, October 2002.
Wang, Xiaohong M.D.; McCulley, James P. M.D.; Bowman, R. Wayne M.D.;
Cavanagh, H. Dwight M.D., Ph.D.
Abstract:
Purpose. To evaluate the resolution of contact lens-induced corneal warpage
before keratorefractive surgery.
Results. The average recovery time for stabilization of refraction,
keratometry (change within +/- 0.5D), and topography pattern was 7.8 +/-
6.7 weeks (range 1 to 20 weeks). Recovery rates differed between the lens
types: soft extended-wear 11.6 +/- 8.5 weeks, soft toric lens 5.5 +/- 4.9
weeks, soft daily wear 2.5 +/- 2.1 weeks,
------------------------------------------
and rigid gas-permeable 8.8 +/- 6.8 weeks.
------------------------------------------
To me, this means an upper limit of 15.6 weeks following RGP lens wear.
DrG
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| Glenn - USAEyes.org 2004-12-21, 2:11 am |
| Thanks for bringing this up. It looks like we could be even more
conservative.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Richard 2004-12-21, 11:09 am |
| "Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote in
news:Xns95C5DEAE758CAdrgleukomacom@204.127.204.17:
> Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in
> news:61oes0t1skeiibil17ddr940cn605v0dq9@4ax.com:
>
>
> Time to Resolution of Contact Lens-Induced Corneal Warpage Prior to
> Refractive Surgery. CLAO Journal. 28(4):169-171, October 2002.
> Wang, Xiaohong M.D.; McCulley, James P. M.D.; Bowman, R. Wayne M.D.;
> Cavanagh, H. Dwight M.D., Ph.D.
>
> Abstract:
>
> Purpose. To evaluate the resolution of contact lens-induced corneal
> warpage before keratorefractive surgery.
>
> Results. The average recovery time for stabilization of refraction,
> keratometry (change within +/- 0.5D), and topography pattern was 7.8
> +/- 6.7 weeks (range 1 to 20 weeks). Recovery rates differed between
> the lens types: soft extended-wear 11.6 +/- 8.5 weeks, soft toric lens
> 5.5 +/- 4.9 weeks, soft daily wear 2.5 +/- 2.1 weeks,
>
> ------------------------------------------
> and rigid gas-permeable 8.8 +/- 6.8 weeks.
> ------------------------------------------
>
> To me, this means an upper limit of 15.6 weeks following RGP lens
> wear.
>
> DrG
>
Personally, I'd use the maximum time to stabilization as the lower limit
for how long to stop wearing prior to surgery, and likely pad that a bit
too, as that is probably something along the lines of the 95% or 99%
confidence number I would expect.
--
Richard
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| Dr. Leukoma 2004-12-21, 7:11 pm |
| Richard <RichardRapier@netscape.net> wrote in
news:Xns95C655A607C3Crichardrapiernetscap@130.133.1.4:
> "Dr. Leukoma" <drgNOSPAM@leukoma.com> wrote in
> news:Xns95C5DEAE758CAdrgleukomacom@204.127.204.17:
>
>
> Personally, I'd use the maximum time to stabilization as the lower
limit
> for how long to stop wearing prior to surgery, and likely pad that a
bit
> too, as that is probably something along the lines of the 95% or 99%
> confidence number I would expect.
>
Yes, I meant lower limit.
DrG
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| John Miles 2004-12-23, 7:11 pm |
| In article <Xns95C5DEAE758CAdrgleukomacom@204.127.204.17>,
drgNOSPAM@leukoma.com says...
> Results. The average recovery time for stabilization of refraction,
> keratometry (change within +/- 0.5D), and topography pattern was 7.8 +/-
> 6.7 weeks (range 1 to 20 weeks). Recovery rates differed between the lens
> types: soft extended-wear 11.6 +/- 8.5 weeks, soft toric lens 5.5 +/- 4.9
> weeks, soft daily wear 2.5 +/- 2.1 weeks,
Wow. If this study is valid, how could contact-lens wearers *ever* have
a 20/20 or better outcome? No surgeon I've ever encountered recommends
more than two weeks out for soft lenses or three for torics.
Do experienced surgeons tend to goose the prescription a little for
contact-lens wearers?
-- jm
------------------------------------------------------
http://www.qsl.net/ke5fx
Note: My E-mail address has been altered to avoid spam
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| Glenn - USAEyes.org 2004-12-23, 7:11 pm |
| >Wow. If this study is valid, how could contact-lens wearers *ever* have
>a 20/20 or better outcome? No surgeon I've ever encountered recommends
>more than two weeks out for soft lenses or three for torics.
>
>Do experienced surgeons tend to goose the prescription a little for
>contact-lens wearers?
It is possible that surgeons will attempt to adjust their nomograms to
compensate for patients who have been wearing contact lenses, but it
seems very unlikely that the doctors have the control necessary to
deal with these nuanced changes that vary across the cornea. In the
case of wavefront-guided ablations, there is little the doctor can do
other than reduce or increase the overall correction, and this is
generally not recommended.
It seems that it would be in the best interest of all that patients be
out of contact lenses longer and longer.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Dr. Leukoma 2004-12-23, 7:11 pm |
| John Miles <jmiles@pop.removethistomailme.net> wrote in
news:MPG.1c34a4b2513df1bb989761@news-central.giganews.com:
> In article <Xns95C5DEAE758CAdrgleukomacom@204.127.204.17>,
> drgNOSPAM@leukoma.com says...
>
>
>
> Wow. If this study is valid, how could contact-lens wearers *ever*
> have a 20/20 or better outcome? No surgeon I've ever encountered
> recommends more than two weeks out for soft lenses or three for
> torics.
>
> Do experienced surgeons tend to goose the prescription a little for
> contact-lens wearers?
>
> -- jm
>
> ------------------------------------------------------
> http://www.qsl.net/ke5fx
> Note: My E-mail address has been altered to avoid spam
> ------------------------------------------------------
The study was performed on patients who had exhibited corneal warpage
from wearing contact lenses, which is an extreme form of corneal change.
The problem as I see it is in someone being able to identify "corneal
warpage." The study suggests that it can take longer than commonly
thought for corneal changes to stabilize. Unfortunately, asking a
patient to be out of their contact lenses for two to three months and
wear eyeglasses prior to LASIK does not fit in with the fast-food
mentality of the typical consumer.
DrG
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