For keratoconus patients, contact lens fit, wearing comfort and cost may be more important than lens performance even in the most advanced designs, a team of researchers from India suggest.

Their study measured spatial vision, stereoacuity and optical quality in 28 bilaterally mild to advanced keratoconus patients who were between the ages of 20 and 28 and new to contact lens wear, in addition to 10 age-matched controls. In randomized order, measurements were taken in keratoconus patients in a variety of wear settings: in spectacle lenses, rigid gas permeable (RGP), Kerasoft, Rose K2 and scleral RGP lenses. The measurements were done a week apart from each other.

The study noted all outcomes deteriorated with keratoconus severity and improved with CL wear relative to spectacles. The improvement was smaller for Kerasoft lenses and higher but comparable for the other three CL designs across all disease severity. Visual function and optical quality outcomes never reached control levels for any correction modality, the investigators said.

“Visual performance and optical quality in keratoconus does not appear to improve commensurately with the sophistication of CL design across disease severity,” the researchers wrote in their paper. “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.”