Decoding Cone Morphology in Keratoconus: A Retrospective Study on Contact Lens Selection in Turkish Patients

Area of Science:

• Ophthalmology
• Corneal Diseases
• Optometry

Background:

• Keratoconus is a progressive corneal ectasia affecting vision.
• Appropriate contact lens selection is vital for visual rehabilitation in keratoconus patients.
• Understanding the relationship between cone morphology and lens type is crucial for effective management.

Purpose of the Study:

• To explore the link between cone morphology and contact lens selection in keratoconus.
• To evaluate how keratometry, cone shape, and disease severity influence contact lens fitting and visual outcomes.
• To optimize contact lens fitting and visual rehabilitation for keratoconus patients.

Main Methods:

• Retrospective analysis of 108 eyes from 73 keratoconus patients.
• Classification of keratoconus by morphology (central, oval, globus) and Amsler-Krumeich grade.
• Correlation of patient data, topography, and prescribed contact lens types (scleral, hybrid, RGP, toric).

Main Results:

• Scleral lenses were most common (50%), especially for advanced (globus, Grade 4) keratoconus.
• Hybrid and rigid gas permeable (RGP) lenses were used for moderate cases; toric lenses for mild.
• Best-corrected visual acuity significantly improved from 0.85 to 0.07 logMAR (P < 0.0001) post-fitting.

Conclusions:

• Individualized contact lens selection based on keratometry, cone morphology, and severity is key for keratoconus management.
• Scleral lenses are preferred for advanced keratoconus; hybrid/RGP for moderate.
• Tailored lens fitting strategies significantly improve visual outcomes and guide clinical decisions.