Piggyback lenses in keratoconus.

Intolerance to rigid contact lenses in keratoconus may occur as a result of epithelial pathology or a suboptimal fitting. The application of a soft lens as a bandage makes it possible to tolerate a rigid lens over it. This study gives the results of 40 eyes in 26 patients who were consecutively fitted with a new aspheric combination lens. Thirty-five eyes (87.5%) showed no discomfort, acceptable wearing time, and visual acuity. Four of these eyes showed an improvement of the corneal condition, eliminating the need for a further piggyback wearing system. Failures were found in five eyes (12.5%), which were caused by giant papillary conjunctivitis (two eyes), severe keratoconus (one eye), difficulty in lens handling and lack of motivation (two eyes). The successful use of an aspheric piggyback combination lens in rigid lens-intolerant keratoconus may preclude early surgical therapy.