Discontinuation of long term orthokeratology lens wear and subsequent refractive surgery outcome.

PURPOSE: To report a case of lens discontinuation in a long term orthokeratology (OK) lens wearer and describe regression in refraction, corneal topography, and corneal thickness over 408days after lens discontinuation. Furthermore, the outcome of subsequent LASIK treatment is also reported.

CASE REPORT: A 41year old Caucasian female who had been previously wearing OK lenses for 13 years discontinued lens wear in the left eye to consider refractive surgery in that eye. The greatest changes in subjective and objective refractions, corneal topography and thickness occurred during the first 28days after lens discontinuation. Subjective refraction did not reach baseline values, but corneal topography parameters returned to pre-OK values after 408days of no lens wear. The patient then received successful refractive surgery treatment in that eye, achieving uncorrected visual acuity of 0.00 LogMAR units, and residual refractive error within ±0.50D of emmetropia.

CONCLUSION: The period of lens discontinuation required for long term OK lens wearers before refractive surgery is likely to vary between individuals and the patient described in this case report required a significant period of lens discontinuation of at least one year before being considered suitable for refractive surgery.