[Keratoconus and contact lenses (author's transl)]

Area of Science:

• Ophthalmology
• Corneal Diseases
• Contact Lens Technology

Context:

• Keratoconus is a progressive corneal ectasia affecting visual acuity.
• Contact lens fitting is a common management strategy for keratoconus.
• Long-term outcomes and contraindications for contact lens wear in keratoconus require ongoing investigation.

Purpose:

• To review the efficacy and outcomes of contact lens fitting in a cohort of keratoconus patients.
• To identify contraindications for contact lens wear in keratoconus.
• To evaluate the role of contact lenses before and after keratoplasty.

Summary:

• A 1-12 year follow-up of 82 keratoconus cases revealed 66 were fitted with contact lenses.
• Contraindications included better spectacle acuity, advanced disease, unilateral cases, and associated ocular conditions.
• Both hard corneal and soft lenses were utilized, with high tolerance (80% wearing >10 hours/day).
• Contact lenses did not alter disease progression, often necessitating keratoplasty. Post-keratoplasty, reduced wear time is advised to prevent neovascularization.
• Soft lenses serve as an option when hard lenses fail or pre-keratoplasty, with specific fitting parameters.
• The "piggy back" method (hard over soft) and potential iatrogenic keratoconus from long-term lens wear were noted.

Impact:

• Provides insights into contact lens management for keratoconus, guiding clinical practice.
• Highlights the limitations of contact lenses in halting keratoconus progression, emphasizing surgical intervention.
• Informs patient selection and management strategies for contact lens wear, particularly in the context of keratoplasty.