Surface topography of soft contact lenses for neutralizing corneal astigmatism

We compared the surface topography of 38 soft contact lenses in situ to the corneal topography of 17 patients. The analyzed lenses consisted of patients' spherical and toric lenses as well as additional spherical lenses of various thicknesses. Thirteen brands of contact lenses were worn; corneal astigmatism ranged from 0.12 to 3.81 D. Our hypothesis was that toric soft contact lens neutralization of corneal surface astigmatism occurred through the creation of a more spherical anterior surface. Videokeratoscopy was used to analyze corneal surface changes with contact lens wear. The correction of astigmatism for toric corneas (toricity > 0.75 D) fit with toric lenses (i.e., the difference between the surfaces of the cornea and anterior lens) showed surface astigmatism neutralization of only 34 +/- 38%. The greater the astigmatism, the greater the neutralization. Spherical lenses not only failed to mask corneal toricity, but actually increased it. The topographic map can be a valuable asset for analyzing and possibly improving contact lens fitting of toric contact lenses.