Taking Contacts out 24 Hours Before Lasik Surgery, Too Soon?

Question

I had an evaluation to see if I am a Lasik candidate yesterday. They instructed me to take my contacts out for 24 hours before the appointment. They did all of the tests yesterday then offered to get me in to surgery tomorrow.Everything I am reading online is saying to have your contacts out at least 2 weeks prior to your evaluation.   Is this Lasik company pushing this too fast? Do I need to give my eyes more time to adjust to their natural shape?

Jon Dishler, MD, FACS · Answer

I totally agree with your concern of being told that you only need to leave your contact lenses out for 24 hours prior to LASIK.  And you are correct about the reason as well.  The shape of the eye can change with removing contact lenses and this period of waiting is needed to allow the eyes to stabilize.  In general most doctors wait at least a week for soft lenses, and two weeks for toric soft lenses prior to performing surgery.  It is sometimes also helpful to have a second exam to be sure that there is no further change in the prescription.  For hard or gas permeable lenses this period of time needs to be longer, sometimes several months.
Any laser center that tells you to just leave your lenses out overnight and have the procedure is not taking this into account and you may wish to get a second opinion from another doctor in your area.
LASIK is an elective procedure, and you should also have some time to think about the advice you have been given prior to making a final decision on having LASIK performed and where you will have it performed.
I certainly do not want to be critical of any other practice, especially without knowing all of the facts.  But from what you have told me, I agree that you should proceed with caution.  All of the FDA studies for the approvals of LASIK required patients to leave their contacts out for some period of time consistent with what was already mentioned above.

Anthony J. Kameen, MD (retired) · Answer

The situation as you describe it is worrisome. I have no problem with a patient leaving their contacts out just 24 hours before their evaluation for LASIK. This exam is mainly to make sure the patient is a candidate and to educate them on the procedure. To be told it is ok to leave your contacts out just 48 hours before the LASIK procedure is not right and you maybe are being rushed here. I recommend at least 10 days out of regular soft lenses, 2 weeks out of toric lenses and one month per decade of wear for gas permeable and hard lenses. Failure to follow these guidelines raises your risk of needing an enhancement significantly.

Gary Kawesch, MD (retired) · Answer

Contacts can distort the shape of the cornea, and the measurements used to program the laser for LASIK.  It is generally recommended that soft contacts should be out at least a week, and with newer wavefront treatments which are higher resolution, even two weeks.  Rigid gas permeable (RGP) and hard contacts should be out at least 3 weeks, and some practitioners advise one month for every 10 years of wear.
Contacts can not only change the preoperative measurements and hence the predictability of your surgery, they can also alter the shape of the cornea and make it unclear for your surgeon if your corneal is normal or not.  Contact lens induced corneal warpage is a situation diagnosed on topography, or corneal mapping, and this condition can mimic a condition called inferior corneal steepening, or forme-fruste keratoconus.  With these conditions, LASIK may pose increased risk, and a procedure such as PRK may be safer.
So, one day is usually not enough.  It will increase your risk of needing a touchup, and, depending on your corneal topography, you may be getting LASIK when you ought to have PRK (unlikely but possible).
Hope this helps.

Taking Contacts out 24 Hours Before Lasik Surgery, Too Soon?

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Taking Contacts out 24 Hours Before Lasik Surgery, Too Soon?

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