How long do I need to go without wearing my hard lenses before having lasik surgery?
How Long to Wait for Lasik Surgery Without Wearing Hard Lenses?
Doctor Answers 5
LASIK surgery (Laser Eye Surgery) with a history of wearing hard contact lenses.
The longer you wait to have LASIK surgery, often referred to as laser eye surgery, the better! RGP contacts (hard contact lenses) work by distorting the shape of the cornea (the front surface of your eye) and in order to do LASIK effectively we need your cornea to be in it's natural state. If you have LASIK done too early after wearing hard contact lenses then the measurements that will be input by the ophthalmologist into the laser won't be based on your natural corneal shape. Your eye will continue to return to its natural state even after LASIK and so your results will not be as effective as they could have been, which may result in re-treatment.
The most conservative and, therefore, safest rule is to leave them out for 6 weeks for every 3 years you have worn hard contacts, up to a maximum of 6 months.
For example if you have worn hard contact lenses for 2 years and want to get LASIK surgery done as soon as possible then, you would have to wait 6 weeks while you wore glasses before I'd consider it safe to proceed.
How Long To Keep Out Hard Contact Lenses Before LASIK
My rule of thumb for leaving out hard or gas permeable contact lenses before Lasik surgery is "one month per decade of wear." Now, I know you are groaning, but this has been my rule for the 18 years I have been performing Lasik in the US and a few years before that during the FDA trials. What this does is give the corneas time to go back to their natural shape, rather than their lens warped state. Sometimes as a bridge, if the time period is going to be 3 or 4 months, we will fit the patient with soft contacts that they can wear up until about 10-14 days before the procedure, then, they too have to come out and glasses worn until surgery. I have had many patients tell me that the contact lens "holiday" is the hardest part of the procdure! But it is worth it!
Time out of Gas Permeable Lenses before LASIK
Unlike soft contact lenses, gas permeable lenses can substantially change the shape of the cornea. The absolute answer for the time to be out of gas permeable lenses is based on serial refractions and measurements of the cornea called topography. A good rule of thumb is one month per decade of wear. If not enough time is spent out of lenses, it is probable that an enhancement procedure would be required that may be much more difficult than just having waited. It is usually possible for most to switch to soft lenses during this time and then just be out of soft lenses for a week or two.
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Most doctors will suggest that you be without hard contacts for 2-3 weeks prior to surgery. This is because the hard contact lens itself can change the shape of the cornea and change the prescription of the eye.
Hard contacts RGP before LASIK LASEK
the rule of thumb in the textbooks used to be 1 month out of RGPs for each decade of wear. in reality, this rule is overly conservative, and you don't need to wait that long
i am recommending a newer rule of thumb, which is a month out, then do a topography or orbscan or wavescan to check for warpage
it's not the time out that matters, it's however long it takes to unwarp
the tricky thing is after RGPs your astigmatism actually goes UP in the unwarping process, as compared to soft lenses, where it goes down, so your doctor needs to know this and wait for your astigmatism to increase to the max value (kind of opposite)
hope this isn't too confusing :)
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