Consultant's Corner

Fitting Post LASIK, RK and PRK Patients with Reverse Geometry Lenses

by Janet Gilman, COT, FCLSA
Consultation Manager

At Art Optical, we recognize the increasing need for reverse geometry lenses for patients who have had LASIK, Radial Keratometry, or PRK. These patients need a good fitting lens to accommodate their flat central corneal curvature and their steeper peripheral cornea. Did you know that we offer reverse geometry lens fitting, design and consultation services for these irregular corneas?

Ideally, for consultation to assist in designing a reverse geometry lens, we need a color topography. The topography should be formulated in either an axial or tangential map using a normalized scale. If this is not available, we have a loaner reverse geometry fitting set you can use to determine the best fit. Then, do an over refraction, and order from there.

Another way to design these intricate lenses for the post refractive patient would be to obtain the pre-surgical keratometer readings, which can help us determine the reverse curve needed for the lens. These lenses normally need a large diameter (10.0 to 10.5) to center well. We will generally start with a 7.0 optic zone on LASIK patients but may go larger on an RK patient since these ablation areas are usually non-symmetrical and larger than that of a LASIK patient. While the lenses in the fitting set are all -2.00, don’t be surprised if you tend to need more minus in your final lens, similar to what you find with a Keratoconic patient.

The lenses are manufactured in Bausch & Lomb Boston XO® or Bausch & Lomb Equalens® II material with a full 4 month warranty to cover needed exchanges. We highly encourage you to speak with a consultant while working with these patients and making lens adjustments. Our depth of experience in post-surgical fitting can help save you chair time and keep your reorders to a minimum.

We’re always eager to help you help your patients who have had a less than optimum surgical outcome. With reverse geometry lenses, you can improve visual acuity, reduce aberrations, and provide the crisp vision your patients seek.


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