Purpose

While several advanced contact lens (CL) designs are commercially available for vision correction in keratoconus, their visual performance and optical quality, relative to each other and controls remains unclear. This prospective, crossover study tested the hypothesis that these CL designs would have a differential impact on visual performance and optical quality in subjects with advanced keratoconus, but not in early to moderate disease states.

Methods

Spatial vision (logMAR acuity and contrast sensitivity), depth vision (stereoacuity) and optical quality (higher-order wavefront aberrations) were measured on 28 bilaterally mild to advanced keratoconics (age: 20–28yrs; 15 males), novice to CL wear, and in 10 age-matched controls using well-established psychophysical and aberrometry techniques. All data were collected on keratoconic subjects with their spectacles and with conventional RGP, Kerasoft®, Rose K2® and Scleral RGP® CL’s in randomized order, atleast a week apart from each other.

Results

All outcome variables deteriorated with keratoconus severity and improved with CL wear, relative to spectacles (p < 0.05). This improvement was smaller for Kerasoft CL (p < 0.05) and higher but comparable for the other three CL designs (p = 0.3), across all disease severity. Visual functions and optical quality outcomes never reached control levels for any correction modality (p < 0.05).

Conclusion

Visual performance and optical quality in keratoconus does not appear to improve commensurately with the sophistication of CL design across disease severity. Non-visual factors like quality of CL fit, wearing comfort and cost may therefore drive the choice of CL dispensed in keratoconus more than the performance efficacy of these lenses.

中文翻译：

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圆锥角膜的不同隐形眼镜矫正方式的视觉性能和光学质量是否有所不同？

目的

虽然有几种先进的隐形眼镜 (CL) 设计可用于圆锥角膜的视力矫正，但它们的视觉性能和光学质量相对于彼此和控制仍不清楚。这项前瞻性交叉研究检验了这样一个假设，即这些 CL 设计将对晚期圆锥角膜受试者的视觉表现和光学质量产生不同影响，但对早期至中度疾病状态没有影响。

方法

空间视觉（logMAR 敏锐度和对比敏感度）、深度视觉（立体视觉）和光学质量（高阶波前像差）在 28 名双侧轻度至高级圆锥角膜（年龄：20-28 岁；15 名男性）、CL 佩戴新手、并使用成熟的心理物理和像差测量技术在 10 个年龄匹配的对照中进行。所有数据均以随机顺序收集到戴有眼镜和传统 RGP、Kerasoft®、Rose K2® 和 Scleral RGP® CL 的圆锥角膜受试者，彼此至少相隔一周。

结果

相对于眼镜，所有结果变量都随着圆锥角膜的严重程度而恶化，并随着 CL 佩戴而改善（p < 0.05）。对于所有疾病严重程度，Kerasoft CL 的这种改进较小（p < 0.05），但与其他三种 CL 设计（p = 0.3）相比更高，但具有可比性。视觉功能和光学质量结果从未达到任何矫正方式的控制水平 (p < 0.05)。

结论

圆锥角膜的视觉性能和光学质量似乎没有随着疾病严重程度的 CL 设计的复杂性而相应地改善。CL 贴合质量、佩戴舒适度和成本等非视觉因素可能因此比这些镜片的性能更能推动选择在圆锥角膜中分配的 CL。