Contact Lenses After PRK: Timing and Lens Choices

The bandage contact lens

PRK removes the corneal epithelium, and the surface regrows over four to five days. A soft bandage lens is placed at the end of surgery to protect the healing surface from the eyelid, reduce pain and help the epithelium grow evenly. It carries no prescription and must not be removed by the patient; the clinician removes it, typically at the day four or five visit, once the surface has closed. If it falls out early, call the office rather than replacing it.

Why refitting waits

The PRK surface remodels for months, and vision and corneal shape continue to change for three to six months, sometimes longer with higher treatments. A lens fitted too early would be wrong within weeks. Fitting waits for stable tomography and a stable prescription, and a residual prescription is not assessed for enhancement until then either.

Who needs lenses after PRK

• A residual or regressed prescription the patient prefers to correct with lenses rather than a further treatment
• Presbyopia, with multifocal or monovision lenses
• Corneal haze or mild irregularity after PRK, where a rigid or scleral lens improves vision beyond what glasses achieve
• Ectasia after PRK, which is rarer than after LASIK but is managed with cross-linking and scleral lenses

The designs

As after LASIK: custom soft lenses for low prescriptions on a regular cornea; reverse-geometry rigid lenses that match the flattened profile; and scleral lenses for irregularity, haze or dryness. PRK preserves more corneal nerves than LASIK, so post-PRK dry eye is generally milder, which helps lens tolerance.