LAS VEGAS – A new generation of scleral contact lenses is demonstrating significant success in correcting higher-order aberrations (HOAs) in patients with keratoconus, potentially deferring or even eliminating the need for corneal surgery in advanced cases, according to research presented at the Global Specialty Lens Symposium earlier this month.
The Zenlens Chroma HOA lens, manufactured by Bausch + Lomb, was shown to reduce vertical coma by 74.9%, horizontal coma by 78.6%, and spherical aberrations by 75.8% in a study of 15 eyes with keratoconus, according to data analyzed by Jason Jedlicka, OD, FAAO, FSLS, clinical professor and chief of cornea and contact lens service at Indiana University School of Optometry.
“Patients with keratoconus absolutely gain the most [from higher-order aberration-correcting lenses], and that has everything to do with the back surface of their cornea,” Jedlicka told attendees at the symposium. “It’s the posterior cornea that creates the [higher-order aberrations] that are unresolved through a traditional lens.”
The study focused on patients already successfully wearing traditional gas-permeable lenses, but whose vision remained suboptimal. Jedlicka deliberately selected patients with particularly severe aberrations, rather than a broad spectrum of mild cases, to maximize the potential for demonstrable improvement. “You get a lot better outcomes when you choose patients who have one or two aberrations that are just off-the-bar high and everything else is pretty much normal,” he explained.
Researchers compared higher-order aberration measurements taken with both traditional lenses and the Zenlens Chroma HOA. The average root mean square improvement across the three measured aberrations – vertical coma, horizontal coma, and spherical aberrations – was approximately 75%.
“Every patient in the group improved noticeably and significantly,” Jedlicka stated. He believes the lenses represent a shift in the standard of care for keratoconus, moving beyond traditional gas-permeable lenses toward wavefront-guided options. “It should no longer be acceptable for us as practitioners to settle for 20/30 or 20/40 vision for those patients when they could do better.”
Jedlicka disclosed that he receives honoraria from Bausch + Lomb.
