Monday, March 4, 2013

Removing Contact Lenses before A-Scan

Question: My father has thick cataracts and he is 87 years old. He presently wears Acuvue® Oasys® contact lenses for 2 weeks straight because he is disabled, then I put new ones in for him. Should he go without wearing his contact lenses for 2 weeks before getting an A-scan? One eye doctor says yes and the other said not necessary. Question 2: Would there be any other reason for using a toric lens implant on a patient that doesn't have astigmatism?

Answer: Generally speaking removing soft contact lenses 2 weeks prior to an A-Scan is usually not necessary. However, because your father wears the  soft contact lenses for a 2 week extended wear period-and if he has some other even mild predisposition to corneal swelling as a result of reduced cell counts on the  innermost layer of his cornea due to age-it is possible that that there is some corneal swelling and possible distortion. This would make it necessary to remove the contact lenses for some period of time prior to measurement and might explain the difference in opinion between eye doctors. You should follow the specific instructions of the cataract surgeon who is taking the measurements, selecting the lens implant and performing the cataract surgery. There would be no reason for using a toric lens implant in a patient who does not have astigmatism, however, again, with 2 week extended wear in a person with even mildly compromised corneal deswelling capability, there is the  possibility that the  cornea has become “warped’ mimicking the  presence of astigmatism. This will typically resolve after the contacts are removed for a period of time.

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