Our aim is to review current and significant articles on
contact lens wear in
keratoconus patients. A comprehensive literature search of PubMed was performed for the following topics on
contact lens wear in
keratoconus patients: (1) characteristics of
contact lens wearers, (2) safety and efficacy, (3) complications, (4) fitting techniques, (5)
contact lens wear after procedures/surgeries, (6) patient satisfaction. A total of 104 studies were finally selected and reviewed. Gas permeable (GP) lens wear provided significantly better vision than glasses. Special cone design
lenses had better patient comfort levels though there was no difference in best corrected visual acuity among the GP
lenses. Soft
lenses showed good efficacy for the treatment of mild-to-moderate
keratoconus with newer designs improving visual performance such as customised
hydrogel and novel pinhole
lenses. Scleral and hybrid
lenses provide good visual acuity and comfort for keratoconic patients previously intolerant to RGP
lenses. RGP lens wear post-cross linking (CXL) is relatively well-tolerated.
Contact lenses may still be required post intrastromal corneal ring procedures and post
keratoplasty. Scheimpflug imaging and anterior segment optical coherent tomography (ASOCT) are useful in
contact lens fitting. Computerized
contact lens fitting techniques could reduce the chair time of lens fitting as well as improve comfort and visual performance.
Contact lenses play an important role in the visual rehabilitation of
keratoconus patients. New
contact lens designs and materials have significantly expanded the available fitting options for
keratoconus patients. Imaging technology can be utilized to guide
contact lens fitting.