LASER ASSISTED IN-SITU KERATOMILEUSIS (LASIK) FOLLOWING ORTHOKERATOLOGY: A CASE REPORT.

Abstract

BACKGROUND: Orthokeratology uses rigid gas permeable contact lenses to temporarily reduce myopia and corneal toricity. The consequence of modifying the central cornea in orthokeratology results in the potential for fluctuation of refractive error. This may delay eligibility or affect the outcome of Laser Assisted In-Situ Keratomileusis (LASIK) surgery.


CASE REPORT(S). LH is a 41 yo Caucasian female. She was fit for orthokeratology in 1981. Her refraction prior to discontinuing orthokeratology was: OD-1.00-0.50x105; OS plano-0.75x070. She decided to pursue LASIK and was re-fit with disposable soft toric contact lenses. Two days following the re-fit she returned complaining of degrading vision. Her refractive error was: OD-2.75-0.50x010; OS-1.25-0.75x015. Two weeks following the re-fit her refractive error was: OD-2.75-1.25x180; OS-2.00-1.25x170. Spectacles were prescribed and her refractive error remained stable (+/_ 0.25D in any meridian) until her surgery 51/2 months following the re-fit. She underwent LASIK surgery using a LADAR Vision Autonomous Laser with a 7.5 ablation zone. Her unaided acuity was OU 20/15 distance and RS 20 near at her one day post-op. Her one week post-op unaided acuity was OU 20/15 distance and RS 20 near with a refractive error of OD +0.75-0.50x083; OS +0.25DS. Her two and three month visits are similar with the refraction OD at plano.
CONCLUSIONS. It is difficult to know it there will be any long term effects of orthokeratology as it relates to LASIK. This case report will highlight the re-fitting and management of this previous orthokeratology patient for LASIK surgery.