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Normal gas permeable lenses are spherical or steeper in the centre in the periphery (echoing the normal prolate shape of the human eye). However, myopic laser eye surgery patients' corneas are actually flatter in the centre. Those patients who have corneal irregularities such as irregular astigmatism which can only be corrected with gas permeable contact lenses can often be more easily fit with a "reverse geometry" (flatter in the centre) contact lens because it more closely matches the shape of their cornea.
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