Visual quality with corneo-scleral contact lenses for keratoconus management.

Purpose: To assess the visual quality achieved by fitting corneo-scleral contact lenses (CScL) for keratoconus management.

Methods: Thirty patients with keratoconus presented to have CScL fitted because of the unsatisfactory visual quality they experienced with their contact lenses or spectacles. The eye examination included visual acuity assessment, anterior eye biomicroscopy, ocular fundus examination, corneal topographic analysis, endothelial-cell count, contrast sensitivity and aberrometry. The fitting process was performed using a diagnostic trial set. Subjective visual quality and comfort, and contact lens wear time were also reported. Patients were monitored for one year.

Results: Three patients discontinued CScL wear before one year. Therefore, 27 eyes of 27 patients (19 male and 8 female) participated in this study. The mean age was 36.1 ± 13.1 (mean ± SD) years. Statistically significant differences were found in logMAR visual acuity between the best spectacle-corrected vision and after CScL fitting (mean ± SD, 0.23 ± 0.30 and 0.00 ± 0.14, respectively; p < 0.001). The total high-order aberrations decreased significantly (55%), and the spatial frequencies of contrast sensitivity all improved to normal range values of the population. Furthermore, high subjective visual quality and comfort ratings, and prolonged usage times (mean ± SD, 13.44 ± 2.38 h a day) were reported. No adverse ocular effects or clinically relevant changes in corneal parameters, visual quality, comfort or usage time were found one year after wearing CScL.

Conclusion: This CScL seems to be safe and healthy, providing optimal visual quality, comfort and prolonged usage times in patients with keratoconus.