Do visual performance and optical quality vary across different contact lens correction modalities in keratoconus?

Area of Science:

• Ophthalmology
• Optometry
• Vision Science

Background:

• Keratoconus is a progressive eye condition affecting corneal shape.
• Several advanced contact lens (CL) designs exist for vision correction in keratoconus.
• Comparative data on the visual performance of these CL designs is limited.

Purpose of the Study:

• To evaluate and compare the visual performance and optical quality of different advanced contact lens designs in keratoconus patients.
• To test if CL designs have a differential impact on visual outcomes based on keratoconus severity.

Main Methods:

• Prospective, crossover study involving 28 keratoconus patients and 10 controls.
• Measured spatial vision (acuity, contrast sensitivity), depth vision (stereoacuity), and optical quality (wavefront aberrations).
• Compared spectacles, conventional RGP, Kerasoft®, Rose K2®, and Scleral RGP® CLs.

Main Results:

• Visual outcomes deteriorated with keratoconus severity but improved with CL wear compared to spectacles.
• Kerasoft CL showed smaller improvements; other designs showed comparable, higher improvements.
• No CL correction modality achieved control-level visual function or optical quality.

Conclusions:

• Advanced CL designs do not uniformly improve visual performance and optical quality across keratoconus severity.
• Non-visual factors like fit, comfort, and cost may be more critical in CL selection for keratoconus than design sophistication.