Today, we’ll discuss an important topic for our patients undergoing corneal cross-linking (CXL) surgery for keratoconus: when it’s safe to resume or start wearing contact lenses after the procedure. We want to make sure you have all the information you need for a smooth recovery and optimal vision.
What is Corneal Cross-Linking?
Corneal cross-linking is a procedure designed to slow or halt the progression of keratoconus, a condition where the cornea becomes thin and cone-shaped, leading to distorted vision. This procedure involves removing the cornea’s outer layer (epithelium) and applying riboflavin (vitamin B2) and UV light to strengthen the cornea.
The Healing Process
Immediately after surgery, the epithelium is allowed to heal under a bandage contact lens for about a week. During this time, you’ll also use prescribed topical antibiotics, steroids, and sometimes anti-inflammatory medications to support healing.
What to Expect During Recovery
After the initial healing phase, your cornea will continue to stabilise over the next several months. You might notice some temporary haziness and changes in your vision as your cornea reshapes. This is normal and typically resolves within a few months.
Resuming Contact Lens Wear
The timing for resuming contact lens wear varies based on whether you’re an established wearer or new to contact lenses. Here are our recommendations:
Established Wearers
Soft Toric Lenses: For those with mild keratoconus, you can usually start wearing soft toric lenses about 1 month after surgery. However, expect changes in your prescription over the first 2 to 3 months. It’s best to wait until around 3 months post-surgery to refit your lenses.
Gas Permeable and Hybrid Lenses: These lenses can be worn about 1 month after surgery, provided the epithelium has healed. Small adjustments may be needed, but you can often use your pre-surgery lenses.
Scleral Lenses: Since scleral lenses don’t touch the cornea, they can be worn as soon as 2 to 3 weeks after surgery. Minor fit adjustments might be required, but your pre-surgery lenses should generally work well.
New Wearers
If you’re new to contact lenses, it’s advisable to wait a bit longer to allow your cornea to heal completely and avoid any complications from over-manipulating the epithelium. Your optometrist will guide you on the best time to start wearing lenses.
Understanding Prescription Changes
The cornea’s shape will continue to change for several months after cross-linking, which means your prescription may fluctuate. Most changes occur within the first 2 to 3 months, but slight adjustments can continue for up to a year.
Important Considerations
Initial Glasses Wear: You’ll need to rely on glasses for a while as your vision stabilises post-surgery.
Additional Costs: Be prepared for new fees related to contact lens refitting and ordering, separate from the surgery itself.
Ongoing Adjustments: Remember, contact lens fitting after cross-linking is an evolving process. Many labs offer a global period for making changes to your lenses, so rest assured that adjustments can be made as needed.
Conclusion
Your visual recovery after corneal cross-linking is a journey that requires patience and close collaboration with your optometrist. At Westmead Eyes Optomerists, we’re committed to guiding you through each step, ensuring you have the best possible vision outcome. If you have any questions or concerns about your contact lens wear post-surgery, don’t hesitate to reach out to us!