Wavefront-Guided Contact Lens Corrections – Increasing Choice for the Individual with Keratoconus Proceedings of the International Forum on Scleral Lens Research

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Jason Marsack
Raymond Applegate


Wavefront-Guided Contact Lens Corrections, Keratoconus, International Forum on Scleral Lens Research


If one were to ask an individual with keratoconus what need they hope to meet with an optical correction, the response would be as varied as the number of individuals diagnosed with the disease. Keratoconus impacts individual patients in myriad ways, and different aspects (or dimensions) of the correction are important to each individual patient. From our work in the laboratory, several recurring, and at times competing, dimensions have come to the forefront. For example, visual and optical performance may be of the utmost importance for one patient, while comfort and an ability to wear the lenses for the majority of waking hours may be paramount for another. Given that no single correction can meet the needs of every individual with keratoconus (just as no single correction can meet the needs of the typical population) a pressing need in regards to optical correction for the individual with keratoconus can be summarized in two words: increased choice.

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1. Zadnik K, Barr JT, Edrington TB, et al. Baseline find-ings in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study. Invest Ophthalmol Vis Sci 1998;39:2537–46.
2. Kosaki R, Maeda N, Bessho K, et al. Magnitude and orientation of Zernike terms in patients with keratoconus. Invest Ophthalmol Vis Sci 2007;48:3062–8.
3. Negishi K, Kumanomido T, Utsumi Y, Tsubota K. Ef-fect of higher-order aberrations on visual function in keratoconic eyes with a rigid gas permeable contact lens. Am J Ophthalmol 2007;144:924–9.
4. Marsack JD, Parker KE, Pesudovs K, Donnelly WJ 3rd, Applegate RA. Uncorrected wavefront error and visual performance during RGP wear in keratoconus. Optom Vis Sci. 2007;84:463-70.
5. Salmon TO, van de Pol C. Normal-eye Zernike coeffi-cients and root-mean-square wavefront errors. J Cataract Refract Surg. 2006;32:2064–74.
6. Applegate RA, Donnelly WJ 3rd, Marsack JD, et al. Three-dimensional relationship between high-order root-mean-square wavefront error, pupil diameter, and aging. J Opt Soc Am A Opt Image Sci Vis 2007;24:578–87.
7. Gumus K, Gire A, Pflugfelder SC. The impact of the Boston ocular surface prosthesis on wavefront higher-order aberrations. Am J Ophthalmol 2011;151:682–90.
8. Sabesan R, Johns L, Tomashevskaya O, et al. Wavefront-guided scleral lens prosthetic device for keratoconus. Optom Vis Sci 2013;90:314–23.
9. Marsack JD, Ravikumar A, Nguyen C, et al. Wavefront-guided scleral lens correction in keratoconus. Optom Vis Sci 2014;91:1221–30.