I had LASIK in Oct. 2003 and am experiencing ghosting, some halo, and farsightedness. To address the ghosting I'm being fitted for RGP contacts. We've been trying larger size contacts (don't know the brand but they cover the entire colored part of the eye) but after 5 hours or so of wearing they leave an imprint on the whites of my eyes (they're moving nasal). I stopped wearing these lenses, but the right lens actually felt pretty comfortable (with one exception, see below) and did eliminate most of the ghosting. The left still irritated me. We're now trying smaller lenses - I'll pick them up this Friday. My question is - what is the impact of this imprinting effect? I wore RGP lenses for 22+ years before LASIK, so I had no trouble with contacts before.

One time the right lens shifted a bit and I wasn't at a place where I could take the lens out. When I finally did take the lens out, my vision out of my right eye was blurry or opaque, like there was a blurry spot on my eye. It eventually went away, and I wonder if some tissue somehow was worn away when the lens shifted and then regenerated after several hours. What could be the explanation?

Thanks again!

The RGP lens covers corneal irregularities with an optically correct surface. Ideally the center of the lens should be within 0.5 mm of the center of the cornea. Post-LASIK, this requires some expertise to achieve. The degree of fitting difficulty is directly proportional to the amount of ablation.

When a post-LASIK RGP de-centers, it molds the cornea into an optically asymmetric shape. When you remove the lens, this altered shape is responsible for the reduction of your vision. The goal of RGP fitting is to wear the lens and have either no post-wear blur or to actually improve the post-wear vision.

On RGP-wearing, non-ablated eyes, little or no spectacle blur is the norm. On post-LASIK eyes, the outcome is not nearly so easy to achieve. It is totally dependent on the design of the RGP. If your lens is not centering, the design work is not complete.

If fitting RGPs is checkers, then fitting post-LASIK corneas with RGPs is chess. It takes longer and there are many more possible moves. Post-LASIK corneas are totally unique to each patient because the degree of pre-operative myopia or hyperopia is independent of the original corneal shape.

I think the term "contact lens", when discussing rehabilitation of post-LASIK vision, is too simplistic. We should be using the term "corneal prosthesis". It leaves, perhaps, a more realistic impression of what post-ablation vision rehab is all about.