Improvement of visual acuity and corneal physiology in keratoconus by fitting aspherical, high oxygen-permeable contact lenses.

Keratoconus is a condition in which the cornea assumes a complex irregular curvature caused by central corneal thinning. The abnormal topography of the cornea in combination with central corneal scarring results in an impaired visual acuity. Even in mild cases spectacles do not correct vision adequately. The use of hard contact lenses with a spherical geometry in the past has already given a marked therapeutic improvement. The use of these lenses however, is complicated by hypoxia and mechanical trauma of the cornea. These complications could theoretically be avoided by fitting elliptical lenses with a high oxygen transmission. To investigate this hypothesis we compared low oxygen-permeable spherical lenses with high oxygen-permeable elliptical contact lenses in a group of twenty patients with mild keratoconus. Our results showed both a marked subjective and objective visual improvement after fitting elliptical lenses with a low incidence of complications.