Rigid Gas Permeable Lenses Associated With Better Visual Quality in Keratoconus

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Clinicians may wish to consider quality of vision factors in addition to visual acuity when fitting these patients with contact lenses.

Rigid gas permeable contact lenses (RGPCL) are associated with better dynamic visual quality in those with keratoconus, according to findings published in Clinical Ophthalmology.

Researchers conducted a retrospective study to analyze visual performance in contact lens wearers with keratoconus. The study included 96 eyes of 59 participants, and it evaluated best-corrected visual acuity with contact lenses (BCVA-CL), best-corrected visual acuity with spectacles (BCVA-S), contrast sensitivity (CS), light scattering in the retina and vision break-up time, and corneal tomography.

The researchers fitted 67 eyes with RGPCL, 17 eyes with hybrid contact lenses (HCL), and 12 eyes with silicone hydrogel contact lenses (HGCL). Dynamic objective scatter index (OSI, P =.024), minimum OSI (P =.037), and maximum OSI (P =.04) were significantly better in eyes with RGPCL compared with those with HGCL. Mean CS under photopic conditions was significantly better with HCL (P =.006), but worse with HGCL, without differences in mesopic conditions (P =.121). A higher mean K (P =.02) and a lower corneal thickness at the thinnest point (P =.011) were observed in RGPCL wearers.

“Since not all types of contact lens are suitable [for] all patients with keratoconus, prescription can be a big challenge,” according to the researchers. “Therefore, one of the aims of this work is to highlight that in [the contact lens] fitting process, professionals must take into account not only visual acuity but also the quality of vision, as this may impact daily-life activities.”

Study limitations include the use of participants with different disease severities, possible confounding due to the study’s retrospective nature, and the lack of a control group.


Marta A, Marques JH, Almeida D, Jose D, Barbosa I. Keratoconus and visual performance with different contact lenses. Clin Ophthalmol. 2021;15: 4697-4705. doi:10.2147/OPTH.S345154