Would there be any reason to suggest that contact lens use could potentially "speed up" the hyperopic shift in RK patients? Is there some sort of "flattening" process on the cornea with contact lens use? I am an RK patient that has not had that much hyperopic shift, but I have also never really worn contacts after my RK.

I am in the process of trying to find a good lens, although I know my corneas have a really irregular surface and EXTREMELY small optic zones, so I do not know how many options I might have for lenses.

However, my near vision is essential to my work, and what little I have, I want to preserve for as long as I can. I am 39 now. If contact lens use can possible slow down this shift, I am even more interested than ever to get good lenses. Thank you!

Also...just to get a professionals thought on this...I read some where in one of these old threads where a doctor suggested that during the sleep process, the pressure of the pillow on the eyes can also speed up this hyperopic shift. Well since my RK surgery never corrected my vision, I have always been dependent on glasses. I have notoriously slept in them for years (I fall asleep with them on while watching TV), and therefore, my eyes never really smash into my pillow. Do you think in some strange way, the combination of not wearing contact lenses and sleeping with glasses on has helped me slow down the hyperopic shift?

Oh, the beauty of RK...all the "benefits" are hypothetical and all the "disadvantages" are real!

CL's shouldn't cause any change that would not occur otherwise. They do have the benefit of giving better clearer vision.

RK is unfortunately a treatment that has been put into the not good surgery basket, and unfortunately it is too late to reverse the problems now.

Find a good OD and discuss the situation. Trial some lenses and see what you think.

There are numerous RK patients who continue to flatten and there are many whose refraction changes throughout the day. This continuing instability of the corneal curvature could be exacerbated by a flat fitting RGP lens. Particularly in RK patients using corneal lenses, we want to use the peripheral cornea to support the lens and avoid excessive bearing centrally.

I think the degree of hyperopic shifting for many RK patients is relative to the number of cuts that were made and the depth of the cuts. Differences in corneal thickness, patient to patient, as well as differences in corneal thickness along the length of the cut could affect the flattening and stability. The concept behind RK flattening, I believe, was the potential for the peripheral cornea to bulge and flatten the cornea centrally. It would seem logical that an RGP, bearing on the peripheral cornea, should retard hyperopic shifting.

The difficulty with all refractive surgery is the application of nomograms that are unable to account for subtle, individual differences in corneal structure and healing.