The Max Schapero Memorial Award Lecture 2004: contact lenses on and in the cornea, what the eye needs.

Purpose: The aim of this study is to review the advances made in understanding the needs of the cornea and the way in which it responds to contact lens wear and corneal implants.

Methods: The review is based on personal knowledge and involvement of the author and colleagues from the 1970s to 2005.

Results: Development of silicone hydrogel contact lenses is presented as well as development of synthetic materials for implantation on the corneal surface (corneal onlay).

Conclusions: The future of vision correction involves developing highly porous and biocompatible lens materials. For contact lenses, a better understanding of the effects of contact lens wear on the ocular surfaces, including the tear film, and development of lens materials with greater bacterial resistance are required. For those who require new solutions to permanent vision correction, corneal onlays (implantable contact lenses) are a minimally invasive and totally reversible procedure that can be removed or replaced as visual needs change over time.