Keratoconic Bi - aspheric Contact Lenses

Aim: This observational clinical case series examined patients with keratoconus (KC) fit with keratoconic bi-aspheric (KBA) lenses to assess visual acuity (VA), wavefront aberrations, physiological fitting, subjective comfort, and manufacturer’s fitting guidelines. Materials and methods: Seven adult patients (11 eyes, four females, mean age: 34.15 ± 14.12) with nipple cones from the Hadassah Academic College contact lens clinic (Jerusalem, Israel) were fit with KBA lenses by modifying the initial base curve (BC) to obtain an acceptable physiological fit. The uncorrected and corrected distance (D) and near (N) Snellen VA and the ocular wavefront measurements, and responses to a self-administered five-point scale questionnaire were compared after 2 weeks of wear using paired two-tailed t-test or MannWhitney U test, as appropriate. Results: Visual acuity and total root mean square (RMS) improved signif icantly with the lenses (DVAuncorrected = 0.04 ± 0.02, DVAcorrected = 0.66 ± 0.22, NVAuncorrected = 0.34 ± 0.30, NVAcorrected = 0.95 ± 0.12). Subjects reported an average of 7.0 ± 2.7 hours of wear daily, with good scores in visual stability, satisfaction with VA and quality of vision, improvement of mood and quality of life, and low scores in foreign body sensation, pain, red eye, and itching during wear, and difficulty with lens removal. An average of two BC modifications from the diagnostic lens were necessary (0.16 mm steeper in nine eyes, 0.27 mm flatter in two eyes). Conclusion: Keratoconic bi-aspheric lenses can provide 7 hours of comfortable wear, significantly improved VA and total RMS aberrations, alongside subjective satisfaction. Base curve modifications can be reduced by fitting a diagnostic lens 0.75 mm steeper than the flattest keratometry reading.