Can Rigid Gas Permeable Lenses Control Astigmatism After LASIK?

Can astigmatism be controlled with rigid gas permeable contact lenses (orthokeratology lenses)?

I underwent SMILE refractive surgery for my myopia in April of this year.
Before the surgery, I had astigmatism of 100 degrees in both eyes.
After the surgery, one eye had residual astigmatism, initially measured at 25-50 degrees, which increased to 50 degrees at four months post-op and recently reached 75 degrees (measured on the computer) at seven months post-op.
My vision has changed from 1.0 to 0.9 on the vision chart.
I would like to ask the doctor if astigmatism can be managed with rigid gas permeable contact lenses (orthokeratology lenses).
I really do not want to return to my pre-surgery level of 100 degrees or higher astigmatism (the corneal topography showed no signs of expansion, as per the doctor).

Yi, 20~29 year old female. Ask Date: 2021/11/22

Dr. Gao Pilin reply Ophthalmology

Hello, after laser surgery, the cornea is different from a normal cornea.
It may be possible to rely on corneal reshaping, but it might be necessary to try it out to see the results.
Please consult your attending physician for testing.

Reply Date: 2021/11/22

More Info

After undergoing SMILE (Small Incision Lenticule Extraction) surgery in April, you are experiencing residual astigmatism in one eye, which has increased from 25-50 degrees to 75 degrees over the past seven months. This situation raises the question of whether Rigid Gas Permeable (RGP) lenses, also known as orthokeratology lenses or corneal reshaping lenses, can help manage your astigmatism post-LASIK.

RGP lenses are designed to provide a more stable and consistent optical surface on the cornea, which can be beneficial for individuals with astigmatism. They work by creating a tear film between the lens and the cornea, which can help to reshape the cornea over time. This reshaping can potentially reduce the degree of astigmatism, especially if the astigmatism is due to irregularities in the corneal surface.

In your case, since you have residual astigmatism after LASIK, RGP lenses could be a viable option to help control and possibly reduce the astigmatism. They can provide clearer vision by compensating for the irregularities in the cornea that may be contributing to your astigmatism. However, it is essential to have a thorough fitting and evaluation by an eye care professional who specializes in contact lenses to determine the best approach for your specific situation.

It's also important to note that while RGP lenses can help manage astigmatism, they may not completely eliminate it. The effectiveness of RGP lenses in controlling astigmatism can vary based on individual factors, including the degree of astigmatism, the shape of the cornea, and how well the lenses fit. Regular follow-ups with your eye care provider will be necessary to monitor your vision and make any necessary adjustments to your lens prescription.

Additionally, if you are concerned about the potential for your astigmatism to worsen or return to pre-surgery levels, it may be worth discussing with your ophthalmologist the possibility of further corrective options. These could include enhancements to your LASIK procedure or other surgical interventions that may be appropriate for your condition.

In summary, RGP lenses can be an effective tool for managing residual astigmatism after LASIK, but their success will depend on individual circumstances and proper fitting. It is crucial to maintain open communication with your eye care provider to explore all available options and ensure the best possible outcome for your vision.

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