Review Article

Nonsurgical Procedures for Keratoconus Management

Table 3

Description of the main studies in keratoconus (KC) managed with rigid gas permeable contact lenses (RGPCLs).

AuthorType of studySample size (eyes)Severity KCFollow-up (months) (mean)Age (years) (mean ± SD)Sex (male/female)UCVA (logMAR)BCLCVA (logMAR)Comfort levelOther findings

Zadnik et al. [98]Cross-sectional, observational2418Mild (110 eyes), moderate (1172 eyes), severe (1130 eyes)NR39.3 ± 10.955.9%/44.1%Entrance VA.
(Patients)
0.0 or better: 409
>0.0 to 0.3: 693
>0.3 to 0.54: 84
>0.54 to 1.0: 18
>1.0: 18
(Patients)
0.0 or better: 538
>0.0 to 0.3: 612
>0.3 to 0.54: 43
>0.54 to 1.0: 10
>1.0: 1
72.8% comfortable
27.1% irritating at least one eye
SCL: 4%
RGPCL: 73%
Piggyback: 2%
Hybrid: 3%
Eye rubbing: 50.4%
Vogt’s striae: 65%
Fleischer’s ring: 86%
Corneal scarring: 53%
Corneal irregularity: 99.7%
Bilgin et al. [41]Retrospective, cohort1004Mild (5 (47%))
Moderate (4 (5%))
Severe (40.1%)
18–3034.8 ± 10.152.7%/47.3%0.62 mild
0.70 moderate
1.30 severe
0.10 mild
0.10 moderate
0.22 severe
New adaptation due to intolerance and irritation:
32.7% mild KC
23.7% moderate KC
17.6% severe KC
PKP: 2.0%
Acute hydrops: 0.3%
Unilateral KC: 10.6%
Cone like shape: 20.6%
Subepithelial opacity: 14%
Descemet folds: 8.6%
Fleischer’s ring: 1.8%
Munson’s sign: 6.2%
Vogt’s striae: 7.5%
Hwang et al. [35]Prospective, case–control107Mild (3.7%)
Moderate (43.9%)
Severe (52.3%)
22.625.4 ± 6.8 cases
22.3 ± 7.7 controls
53.3%/46.7%Spectacle corrected
0.68 cases
0.54 controls
−0.032 cases87% comfortable
9.1% slightly uncomfortable
3.9% uncomfortable
Kamar et al. [33]Prospective, cohort30Mild (4 eyes)
Moderate (14 eyes)
Severe (12 eyes)
2248.5 ± 9.950%/50%Contact lens corrected
0.20
Pancorneal RGPCL
0.15
6.6% intoleranceImprovement in corneal compression: 77%

SD: standard deviation; UCVA: uncorrected visual acuity; BCLCVA: best contact lens corrected visual acuity; HOA: high ocular aberration; PKP: penetrating keratoplasty. Mild KC (average sim K < 45 D). Moderate (average sim K 45–52 D). Severe (average sim K > 52 D).