Toric Lenses and Wavefront iLasik Pre-op Timing

I have read varying timetables regarding the discontinuation of toric lens wear prior to a Lasik pre-op appointment. I have heard 2 weeks, which was my own doctors recommendation, and have also heard 3 weeks from other sources. I discontinued wear of my toric lenses on the 27th of December, and just had my pre-op on the 11th of January. I feel like I should pay for another pre-op that conforms to the 3 week timetable, if for nothing more than peace of mind. Could my corneal topography be off?

Doctor Answers 5

LASIK and contact lenses

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There is no hard and fast rule on lens discontinuation.  Two weeks is generally considered sufficient by most doctors but there is nothing wrong with waiting 3.  Ask to have your topography/measurements repeated.  If you have not had your surgery yet, maybe just coming in a little earlier on the day of surgery for a repeat topography would give you piece of mind (if your surgeon's schedule permits).

Raleigh-Durham Ophthalmologist

Toric lenses and ILASIK pre op testing

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We recommend 3 weeks out of toric lenses prior to the wavefront testing David, but there are probably other doctors that feel 2 weeks are enough.    If you were our patient, yes, you would have another wavescan performed prior to your procedure, but you wouldn't be charged for it, all of this type of testing really should be included in the total price.  Topography should be repeated so that it is obvious that there is stability in the corneal curvature and elevations.   It is obviously best when you can trust the Doctor to do what is best for you in a situation such as this.  Best of luck, Dr Holzman

Andrew E. Holzman, MD
McLean Ophthalmologist

Timing of no contacts pre LASIK LASEK

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look, any timing you hear or read about no contacts out is only a VERY ROUGH RULE OF THUMB. i've had patients in lenses where they take the lens off in front of us, we do the topography, and it is NORMAL WITHOUT ANY WARPAGE (implying they have a good fit, it is not tight and they are not wearing it overnight). i;ve also had patients come in with no contacts for a MONTH, and the cornea is STILL WARPED (from a bad or tight fit, or abuse like overnight wear)


"gold standard" btw is NOT a topography anymore, but an OrbScan or Pentacam, both of which cost about $50,000 (compared to a topo unit for $5,000) and both of which are more sensitive to detecting Keratoconus, which is the disease that can look like contact lens warpage, which you are trying to pick up (and not laser)

your surgeon should have explained this all to you, btw. also, preop testing before LASIK (which i don't do anymore, as it is unsafe in the in-between cases, ie a little warpage), and LASEK (which i only do now, as it is 10x safer in these in-between cases, like those with mild inferior steepening on Orbscan) is supposed to be FREE. i've sometimes seen patients a half dozen times preop, keeping their contacts out, until i get a normal Orbscan, because i don't want to discourage my patients from getting a perfect preop (by charging for it)

Emil William Chynn, MD, FACS, MBA
New York Ophthalmologist

Contact lens down time before laser vision correction

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My personal rule of thumb on this is 'the longer the better.' Two weeks is the absolute minimum for soft contact lenses and some will recommend longer for toric soft lenses. For hard and RGP contact lenses the down time is even longer. Two weeks is usually enough time for the corneal curvature to stabilize but if you want to be extra sure then ask your surgeon to repeat the keratometry, refraction and topography again after 3 or 4 weeks into the contact lens holiday. If all the measurements are stable then you're ready for surgery.  


Christopher Starr, MD
New York Ophthalmologist

Toric lenses and iLasik

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Your peace of mind is important. I would hope any surgeon would agree to re-measure you. In my practice, 2 weeks for soft toric contacts is recommended. For rigid or hard contact lenses, we recommend at least a month out of contacts, however it can take longer than 4 weeks. What we want to see is stability (no change) in measurements such as topography (corneal mapping), pachymetry (thickness) and refraction (prescription). Sometimes we will switch rigid contact lens wearers to soft and then discontinue the soft lens to reduce time in glasses pre-operatively.

Christopher Coad, MD
New York Ophthalmologist

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