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Originally posted by wyldaisy:
What would be an example of a contact "brand" that bears on the peripheral cornea?

Most post-RS corneas are unique to each individual. A "brand" is only indicated if the design can be made to work with your corneal topography. Any RGP can be made to bear on the peripheral cornea.

Second RGP (Failed-cornea too irregular)
Next step, reverse geometry RGP?

RGPs are indicated for irregular corneas. While most people would point out the differences between standard and reverse geometry RGPs, the distinction is not what "type" but how to design a lens that fits well across its entire diameter. A standard geometry lens, under some circumstances, may work while a poorly fitted reverse RGP would not work.

Do I want to even go down this road if there is a chance that the flat fitting RGP may exacerbate hyperopic shift?

If an otherwise well-fitted RGP on an RK cornea flattens the cornea, the lens design should be made to gently vault the central cornea. Notice I said gently - maybe half a diopter.

With my irregular cornea (very irregular RK cornea according to current OD), should I try a macro lens or scleral lens, Z-WAVE? Are these the ones that vault the cornea and rest on periphery?

Theoretically, any lens can work. The effort should be directed towards thoroughly exploring the present design before abandoning one "type" for another.

Current OD believes that unless I have a PRK procedure to smooth out my cornea, a standard RGP won't work.

Why would a standard RGP work after PRK if not before??? PRK is performed on the more central cornea.
You will still have to depend on the peripheral cornea for the fit and you will still have a post-RS cornea.

Having just begun a pursuit of contact lenses, I am not yet willing to say I have exhausted all possibilities, hence I should have PRK...I am a little gun shy of that right now!

Any thoughts would be greatly appreciated.

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