A New Fitting Approach for Providing Adequate Comfort and Visual Performance in Keratoconus: Soft HydroCone (Toris K) Lenses

Abstract

To evaluate the comfort and visual performance of soft HydroCone (Toris K) silicone hydrogel lenses in keratoconus patients. Fifty eyes of 50 keratoconic patients who were fitted with the Toris K lens were included in the study. All patients were evaluated at baseline and after 2 weeks of lens wear. Uncorrected and best-corrected visual acuities were measured. Corneal topography, ocular aberrations, and point spread function (PSF) were obtained using NIDEK-OPD Scan. Comfort level and visual performance in daytime and nighttime conditions were scored from 0 to 5 after 2 weeks of lens wear. Best-corrected visual acuity was significantly better with the Toris K lens (P<0.001). Mean increase in visual acuity with the lens was 4.5 lines. Mean K1, K2, and Kmax values significantly decreased with the lens (P<0.001). Both total and higher-order root-mean-square errors were significantly corrected with the Toris K lens (P<0.001 and P=0.038, respectively). A significant correction of total coma and trefoil aberrations was achieved with the lens. Also, PSF values were significantly increased with the lens (P<0.001). Although comfort scores in 46 eyes (92.0%) were classified as good/excellent, only 4 eyes (8.0%) had moderate comfort scores. Visual acuity was classified as good/excellent in 46 eyes (92.0%) in daytime and in 38 eyes (76%) in nighttime conditions. Soft HydroCone silicone hydrogel keratoconus lenses should be considered as alternative visual correction for keratoconus patients. The soft and full-custom design provides optimal comfort and visual performance for the patients' daily requirements.