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On-eye Performance of Custom Wavefront-guided Soft Contact Lenses in a Habitual Soft Lens-wearing Keratoconic Patient

 

PURPOSE: To assess visual, optical, and fitting characteristics for wavefront-guided soft contact lenses produced for one habitual soft lens-wearing moderate keratoconic eye.

METHODS: A process for production and evaluation of custom wavefront-guided soft contact lenses was developed. Wavefront aberrations were quantified with the COAS-HD wavefront sensor (Wavefront Sciences); soft contact lenses containing both high and low order aberrations were designed with custom software and produced using an ophthalmic lens lathe. Photopic high and low contrast logMAR visual acuity were recorded with the lens in place over an artificial 5-mm pupil and residual 2nd to 10th order root-mean-square (RMS) aberrations were analyzed over a 5-mm pupil. Comparisons were made to the eyes habitual toric soft contact lens using t tests.

RESULTS: Photopic high contrast values for habitual and final custom contact lenses for a 5-mm pupil were 0.07±0.06 and -0.08±0.05, respectively. Photopic low contrast values were 0.730.06 and 0.62±0.07, respectively. Habitual and final custom correction low order RMS over a 5-mm pupil were 2.08 and 0.34 m, and high order RMS levels were 0.77 and 0.39 m, respectively.

Figure

Figure. The optical results of correction of higher order aberration are shown. The uncorrected higher order wavefront error (0.999 m) in panel (a) is negated by the higher order wavefront error in custom contact lens L3 (0.809 m) in panel (b), resulting in a reduced residual higher order aberration (0.386 m) in panel (c).

CONCLUSIONS: The final custom contact lens showed 1.5 lines of improvement for photopic high contrast (P=.03) and 1 line for photopic low contrast (P=.11) over a 5-mm pupil compared to habitual correction. Low and high order aberrations were reduced by 84% and 50% over a 5-mm pupil, respectively. Further improvements in performance of custom lenses may be achieved with further wavefront iterations.

J Refract Surg. 2007;23:960-4

Jason D. Marsack, PhD; Katrina E. Parker, OD; Yafei Niu, MS; Konrad Pesudovs, BS Optom, PhD; Raymond A. Applegate, OD, PhD
From Visual Optics Institute, College of Optometry, University of Houston, Houston, Tex (Marsack, Parker, Niu, Applegate); and the NH&MRC Centre for Clinical Eye Research, Department of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia (Pesudovs).

Presented at the 8th International Congress of Wavefront Sensing & Optimized Refractive Corrections; February 22-25, 2007; Santa Fe, New Mexico.

 

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