Scleral Lenses for Post-LASIK & RK Patients — Restore Your Vision Without More Surgery
Two surgeries. Three pairs of glasses. Contacts that don't work. Years of frustration. This is the appointment that changes everything.
Your Situation Is More Common Than You Think
Approximately 700,000 LASIK procedures are performed in the United States every year. Research consistently shows that 5–10% of patients experience persistent visual symptoms — halos, glare, undercorrection, regression — that leave them dissatisfied with their outcome.
For RK, the numbers are larger in a different way: an estimated 2+ million Americans had the procedure in the 1980s and 1990s. They are now in their 50s, 60s, and 70s — and a significant portion are experiencing the progressive hyperopic shift and irregular astigmatism that were not disclosed as risks at the time.
Most of these patients have been told there is nothing more that can be done. That is rarely true. The problem is almost always that they haven't yet seen a specialist with expertise in post-surgical corneal optics.
Why Scleral Lenses Work When Nothing Else Does
Glasses & Soft Lenses
Try to conform to an irregular corneal shape — and fail. The lens must work WITH the irregularity, bending and flexing over the uneven surface. The result: a corrective prescription that partially works but can never fully address the aberrations.
Result: "Almost right" vision that frustrates both patient and doctor.
Scleral Contact Lenses
Vault completely over the irregular cornea, resting on the white of the eye. The space between the lens and the cornea fills with preservative-free saline. The saline eliminates the optical irregularity. The outer lens surface is perfectly spherical — providing a new, flawless optical surface regardless of what the cornea beneath is doing.
Result: 20/20 or better for most patients who could not achieve it with any other correction.
Dr. Bonakdar has fitted scleral lenses for over 35 years — including 500+ post-surgical patients. He has managed RK corneas since the procedure was being performed in the 1980s, and post-LASIK corneas since LASIK began its widespread adoption in the 1990s. This is not a specialty he recently developed. It is the foundation of this practice.
Scleral Ortho-K: Glasses-Free Days Without Additional Surgery
Scleral ortho-K lenses are large-diameter reverse-geometry lenses worn only overnight. While you sleep, they gently reshape the front surface of the cornea, providing corrected vision throughout the following day without any lens wear.
For post-surgical patients, scleral ortho-K addresses something regular scleral daytime lenses cannot: it can actually change the corneal shape overnight to provide correction during the hours you aren't wearing a lens. The two applications are:
- Post-LASIK under-correction or regression: Patients who achieved good initial LASIK results but have regressed to mild myopia or astigmatism can use scleral ortho-K overnight to provide additional correction, reducing or eliminating daytime prescription needs.
- RK-induced hyperopic drift: RK patients whose prescription has shifted toward farsightedness can often have that drift partially addressed by scleral ortho-K worn nightly, providing clearer unaided daytime vision.
Good Candidates for Scleral Ortho-K
- Stable or predictably changing prescription
- Motivated to wear lenses overnight consistently
- Sufficient residual corneal health
- Post-LASIK with mild residual myopia
- RK patients with mild-to-moderate hyperopic shift
May Not Be Candidates
- Severe corneal ectasia (keratoconus-like thinning)
- Very high or highly irregular astigmatism
- RK with unusual incision patterns or many incisions
- Significant dry eye affecting overnight wear
- Inability to tolerate overnight lens wear
Scleral Lenses Are Right for You If:
- Had LASIK more than 12 months ago with persistent visual complaints
- Had RK in the 1980s or 1990s
- Experiencing halos, glare, fluctuating vision, or undercorrection
- Cannot achieve satisfactory vision with glasses or soft contact lenses
- Want glasses-free daytime vision (Scleral Ortho-K option)
- Seeking medical insurance coverage for medically necessary lenses
The Fitting Process
Post-surgical scleral fitting is more involved than standard fitting. Here is what the process looks like from your first call to wearing your lenses with confidence.
Comprehensive Diagnostic Evaluation
Corneal topography, wavefront aberrometry, and measurement of your optical quality give us a complete map of what your cornea is doing and where the irregularity lies. This takes approximately 60–90 minutes.
Trial Lens Selection & Fitting
We select initial scleral lens parameters based on your corneal maps. You try the lens in-office and we measure your vision and fit. For most patients, the improvement at this first trial is immediate and striking.
Refinement & Custom Order
Based on your trial results, we refine the parameters and order your custom lenses. Post-LASIK and RK corneas often require 2–3 fitting iterations to achieve optimal optics and comfort.
Dispensing & Training
We teach you insertion, removal, and care protocols. Most patients become proficient within 1–2 weeks. Follow-up visits at 1 week, 1 month, and annually ensure continued corneal health and optimal vision.
Doctor's Insight: Scleral Lenses for Post-LASIK & RK
Direct Answers from Dr. Bonakdar
How effective are scleral lenses for post-LASIK vision problems?
Very effective. Most post-LASIK patients achieve 20/20 or better with scleral lenses, even when glasses and soft contacts fail. The key is the fluid-filled vault — it optically neutralizes the irregular corneal surface that LASIK created, providing clear, stable vision.
Can scleral ortho-K work after LASIK or RK?
Yes, for selected candidates. Scleral ortho-K uses large-diameter reverse-geometry lenses worn overnight to gently correct residual refractive error. For post-LASIK under-correction or RK-induced hyperopic drift, this can provide improved daytime vision without any additional surgery.
Will insurance cover scleral lenses for my LASIK/RK complications?
When scleral lenses are medically necessary due to post-surgical irregular astigmatism or corneal irregularity, they are typically covered under medical insurance — not just vision plans. We handle prior authorization and medical billing for our post-surgical patients.
Real Results for Post-Surgical Patients
“I had RK in 1987 and by 2018 I was extremely farsighted. My glasses prescription changed every 18 months. No one told me this would happen. Dr. Bonakdar fitted me with sclerals and explained exactly why RK causes this — and why it will keep shifting. At least now I have clear, stable vision all day while we monitor the progression. I've recommended him to every RK patient I know.”
RK Patient (1987)
Scleral Lens Patient since 2018 — Anaheim, CA
“I had LASIK in 2002 and it went badly. My surgeon told me the results were ‘within acceptable parameters.’ For 20 years I wore glasses that never felt quite right and suffered from halos at night. Dr. Bonakdar tried sclerals in-office and I immediately saw better than I had since before LASIK. I sat in that chair just stunned. Twenty years of disappointment, fixed in one appointment.”
Post-LASIK Patient (2002)
Scleral Lens Patient since 2022 — Irvine, CA
Request Your Post-Surgical Vision Consultation
Tell us your surgical history and your current complaints. We'll schedule a comprehensive evaluation including corneal topography, wavefront aberrometry, and a scleral lens trial — all in one appointment.
Your Surgical Journey Doesn't Have to End in Disappointment
Scleral lenses have restored 20/20 vision for hundreds of post-LASIK and RK patients who were told nothing more could be done. This consultation could be the turning point.