Table 7.
Contact lens efficacy and comfort in keratoconus patients (post-surgery).
| Author | Study design/indications | Contact lens type | No. of eyes | Follow-up (months) | Keratometry (D) | BCLCVA (logMAR) | Contrast sensitivity | Wear-time (hours) | Cons |
|---|---|---|---|---|---|---|---|---|---|
| Unlu et al. [46] | Case series/post-CXL | GP | 30 | 6 | 56.89 ± 4.60 | NA | NA | 13.2 ± 1.7 | NA |
| Sehra et al. [47] | Prospective comparative/post-CXL | GP |
CXL-CL: 26 CXL-GL: 21 K-CL: 25 |
9 (CXL pts), 6 (non-CXL) | NA | NA | NA | NA | Delay in regeneration of CSNP and epithelial cell stress |
| Singh et al. [49] | Prospective interventional case series/post-CXL | GP | 20 | 6 | Mean K: 48.6 ± 3.3 | 0.07 ± 0.10 (p = 0.012) | 1.3 ± 0.2a (p = 0.000); 0.3 ± 0.3b (p = 0.002) | 9 ± 1.89 | NA |
| Visser et al. [48] | Prospective case series/post-CXL | Scleral | 18 | 12 | NA | 0.03 | NA | 16 | NA |
| Fernando-Velazquez et al. [51] | Retrospective case review/post-ICRS | Hydrogel silicone (Kerasoft-IC) | 30 | 10.3 ± 2.3 | NA | 0.04 ± 0.05 (p < 0.0001) | NA | 11.2 ± 1.2 | Corneal injection |
| Carracedo et al. [52] | Prospective, cross-sectional, double-blind/post-ICRS | Soft (Hioxifilcon A and Lucifilcon A) | 14 | – |
Steep K: 52.49 ± 3.05 Flat K: 48.54 ± 3.58 |
Hioxifilcon A: 0.28 ± 0.13 for 0.4 mm (p = 0.046). Lucifilcon A: 0.29 ± 0.18 for 0.4 mm (p = 0.043). |
– | – | – |
| Montalt et al. [53] | Case series/post-ICRS |
Corneo-scleral (Scleracon, Lenticon, Madrid, Spain) |
27 | 12 | Central K: 46.79 ± 4.67 | 0.00 ± 0.12 (p < 0.001) | Improved | 11.78 ± 3.93 | NA |
| Carballo-Alvarez et al. [115] | Case series/post-ICRS | Soft and Piggyback | 47 | 1 | KM3: 47.70 ± 4.65 | 0.07 ± 0.09 (soft lens) | NA | NA | NA |
| Rocha et al. [54] | Retrospective/post-PK |
Mini-scleral GP (ESCLERA™ contact lenses - Mediphacos, Buritis, MG, Brazil) |
27 | NA | Kmax: 58.4 ± 7.8 | 0.09 ± 0.12 | NA | NA | Discontinuation of lens (4 eyes), Microbial keratitis (1 eye) |
| Barnett et al. [55] | Retrospective/post-PK | Jupiter scleral | 48 | 2 weeks–2 years | NA | 20/25 (scleral) | NA | NA | NA |
| Geerards et al. [56] | Retrospective case series/post-PK | Large-diameter (12 mm) tricurve GP | 190 | 6 | Steep K: 44.75 ± 5.32 | 20/25 | NA | 9.2 | Punctate keratitis |
D diopter, BCLCVA best contact lens corrected visual acuity, CXL cross-linking, GP gas permeable, NA not applicable, CL contact lens, GL glasses, K-CL keratoconus patients on contact lens who did not undergo CXL, CSNP corneal sub-basal nerve plexus, ICRS intrastromal corneal ring segment, K keratometry, KM3 mean corneal power in the 3.00 mm central zone, PK penetrating keratoplasty, max maximum.
aLowest spatial frequency.
bHighest spatial frequency.