Change in Soft Contact Lens Protocol

posted Nov 11, 2015, 7:21 PM by Jen Weigel
We are changing the soft contact lens discontinuance protocol.  Basically, we are rolling things back to what things were like pre-Custom VISX days, so this is not as radical as what it might seem at first glance.

Previously, our contact lens protocol was:

- Soft spherical contact lenses:  discontinue 2 weeks prior to TLC pre-op/final scans
- Soft toric contact lenses:  discontinue 3 weeks prior to TLC pre-op/final scans
- Soft extended wear contact lenses:  discontinue 3 weeks prior to TLC pre-op/final scans
- RGP contact lenses:  discontinue approximately 1 month per decade of RGP wear; check scans/MR at TLC approximately monthly while discontinuing RGP wear; can transition to SCL during this time, but pt must ultimately discontinue those SCL according to the above schedule prior to TLC pre-op/final scans

Now, the new contact lens protocol will be:

- All soft contact lenses:  discontinue 1 week prior to TLC pre-op/final scans
- RGP contact lenses:  same as above, no changes 

Important notes:

This will be easier on your patients, of course, but this was NOT the motivating factor for this change in protocol.  We have traditionally made use of two laser platforms - AMO VISX and Alcon WaveLight - but now that we are primarily using the Alcon WaveLight laser platform, we decided to change gradually to the contact lens protocols used in their studies that were submitted to the FDA.  In those studies, the contact lens discontinuance period was three days, and the results were excellent.  (Of note, three days is closer to what cl d/c period used to be pre-Custom days.  While I wasn't practicing then, I certainly have seen this protocol on paperwork when I've reviewed previous charts for records releases.)

Patients can see you at any time - no matter their cl discontinuance time - for their pre-LASIK/PRK vision checks, dilation, but they must discontinue cls according to the new contact lens protocol above before their TLC pre-op appointment.

And, it goes without saying, but this protocol does not replace professional judgement.  If your patient requires more time out of contact lenses, we will explain this to your patients at their consultation appointments.  Examples of cases needing extended cl discontinuance might include dry eyes, irregular scans, fluctuating MR.  

Let us know if you have questions!  - jw
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