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Wavefront-guided scleral lens correction in keratoconus.

Jason D Marsack1, Ayeswarya Ravikumar, Chi Nguyen

  • 1*PhD †BS ‡MBA §OD, MS, FAAO ∥OD, PhD, FAAO University of Houston College of Optometry, Visual Optics Institute, Houston, Texas (all authors).

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Summary

Wavefront-guided scleral contact lenses (wfgSCLs) effectively correct higher-order aberrations in keratoconic eyes, achieving normal visual image quality. However, high-contrast visual acuity did not reach normal levels in this study.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • Keratoconus is a progressive eye condition characterized by irregular corneal shape, leading to significant visual distortion.
  • Traditional contact lenses often struggle to fully correct the complex visual aberrations caused by keratoconus.
  • Wavefront technology offers a potential solution for precisely correcting higher-order aberrations.

Purpose of the Study:

  • To evaluate the performance of wavefront-guided scleral contact lenses (wfgSCLs) in keratoconic eyes.
  • To quantify visual quality using specific metrics and compare wfgSCLs to standard scleral lenses.
  • To detail the design, manufacturing, and evaluation process for wfgSCLs.

Main Methods:

  • Fourteen keratoconic eyes from seven subjects were included in the study.
  • Custom wfgSCLs were designed and manufactured for each eye.
  • On-eye performance was assessed using high-contrast visual acuity and visual quality metrics.

Main Results:

  • wfgSCLs significantly reduced lower-order and higher-order aberrations compared to spherical scleral lenses.
  • Ten of fourteen eyes achieved residual higher-order aberrations within normal limits.
  • Visual image quality metrics were comparable to normal eyes, but high-contrast acuity did not reach normal levels.

Conclusions:

  • wfgSCLs can optically correct higher-order aberrations in keratoconus, yielding visual image quality similar to normal eyes.
  • Further research is needed to determine if long-term wear improves visual performance to typical levels.
  • wfgSCLs represent a promising approach for managing visual deficits in keratoconus.