Correcting anterior corneal aberration and variability of lens movements in keratoconic eyes with back-surface customized soft contact lenses.

Customized contact lenses are limited in their correction performance, especially on irregular corneas, owing to decentration and rotation of the lenses. To overcome this limitation, we proposed to customize the back surface of soft contact lenses to match the anterior irregular corneal surface. These lenses were designed to correct anterior corneal aberrations and to improve lens stability. Although in keratoconic eyes the anterior corneal aberrations were effectively corrected, significant residual aberrations were observed. The internal optics, especially the posterior surface of the cornea, was the main source of these residual aberrations. Compared with conventional soft contact lenses, lens stability, on average over three eyes, was improved by a factor of 2 for horizontal and vertical decentrations and a factor of 5 in rotational orientation with the back-surface customized lenses.