Brief talk on acular and soft contact lenses after refractive surgery. not mine but shared with me by a friend. thought it was informative

1. Managing Post-LASIK
hyperopia with Acular and
Soft CL’s
Michael Duplessie MD.
Bethesda, MD 20817
301.493.6404

2. Case Example
JE, a 19 year old white female
7.5 mm Pupils (Covard)
MR OD -5.25 DS 20/20
OS -5.25-0.25 x 035 20/20
Cyclo OD –5.25-0.50 x 90 20/20
OS –5.25-0.25 x 040 20/20

3. Case Example
Ultrasound pachymetry
OD 490/493/494 microns
OS 490/491/494 microns
Orbscan pachymetry
OD 475 microns
OS 485 microns

4. Good Candidate?
Large pupils
Young age
Thin corneas

5. Surgical Options
PRK or LASIK?
She chose LASIK.

6. Post-OP
1 Day:
VA OD 20/30-2 PH 20/20
OS 20/50+2 +1.00-1.00 x 017 20/30
10 Day Visit:
OD +1.50 20/20
OS +1.50 20/25

7. Post-OP
3+ Week Visit:
OD +1.25 +0.50 x 125 20/20
OS +1.50 +0.75 x 60 20/20-2
Due to the patient’s RE, reading and night
vision complaints, we discussed using
Acular QID OU with a soft contact lens in
an effort to correct the residual refractive
error.

8. Acular and Soft CLs
Acular :
 Causes thickening of the anterior stroma
 Causes epithelial proliferation
 Acular reduces prostaglandin production
by inhibiting cyclo-oxygenase, an enzyme
responsible for prostraglandin synthesis.

9. Acular and Soft CLs
?? --Thought to result
from actions on
proteoglycans

10. Treatment
Patient was fitted with Acuvue 2
(+0.75D, 14.0, 8.7) contacts to be
worn extended wear in each eye
Lots of Tears!

11. Post-OP
5+ Week Visit
Unaided VA:
OD 20/20-
OS 20/25
MR OD +0.50-0.75 x 120 20/20
OS +0.75-1.00 x 65 20/20-1

12. Post-OP
3 Month Visit
Unaided VA:
OD 20/20
OS 20/25
OD +0.50-0.75 x 120, 20/20
OS +0.75-1.00 x 65, 20/20-1

13. Acular with Soft CL’s
Effective weeks 2-4
Patient education
Successfully treat without
surgery
Great technique for nervous
patients