Refractive stability delayed after discontinuation of long-term rigid CL wear

The time it takes for the cornea to return to a stable refractive state after discontinuation of rigid contact lens wear increases with long-term lens use, a group of researchers found. Candidates for refractive surgery who are long-time wearers of rigid gas permeable contacts should be counseled to expect multiple visits before a stable refraction can be obtained, the researchers said.

Stephen D. McLeod, MD, and colleagues at the University of California San Francisco reviewed the charts of refractive surgery candidates to attempt to determine the factors that delayed refractive stability after discontinuation of contact lens wear. They identified 55 eyes of 28 patients with a history of rigid contact lens wear.

Patients had been instructed to discontinue lens wear for 3 weeks before undergoing the initial exam. They were examined at 3-week intervals until a stable refraction was achieved. Stability was defined as a change of within 0.25 D of sphere and 0.25 D of cylinder with less than 25· of axis shift between visits.

Of the 55 eyes, the 31 that achieved refractive stability by the second follow-up visit were labeled the early-stability group. The 24 eyes that required more than two visits were labeled the late-stability group.

No statistically significant differences between the groups were found in age, sex, refractive cylinder, topographic cylinder or spherical equivalent at baseline. The number of years the subjects wore contact lenses was statistically different between the groups (P = .05).

The authors suggest that candidates for refractive surgery who are long-term rigid gas permeable contact lens wearers be counseled that multiple visits will most likely be required before refractive stability is achieved.

The study is published in the November issue of Journal of Cataract & Refractive Surgery.