Downloaded from http://journals.lww.com/optvissci by BhDMf5ePHKbH4TTImqenVAJP5BDjqW51Md+lGjTRvZydfxR0GdyXC5fElEYBeppGgkEoKLrK/xE= on 09/25/2020 Comparison of Corneal Higher-order Aberrations between Miniscleral and Hybrid Lenses in Keratoconus Mehrdad Assadpour, MSc, 1 Payam Nabovati, PhD, 2 Hassan Hashemi, MD, 3 Shokoofeh Rafati, MSc, 1 Abbasali Yekta, PhD, 4 Ebrahim Jafarzadehpur, PhD, 2 * and Mehdi Khabazkhoob, PhD 5 SIGNIFICANCE: Fitting specialty contact lenses (hybrid and miniscleral) can be a useful option in keratoconus pa- tients to decrease higher-order aberrations (HOAs) and increase the quality of vision. PURPOSE: The aim of the present study was to compare corneal HOAs between miniscleral and hybrid lenses in keratoconus patients. METHODS: The target population of this study was 37 patients with bilateral keratoconus aged 20 to 35 years who were referred to a specialized contact lens clinic by a corneal specialist. Pre-fitting examinations included objective and subjective refraction, measurement of uncorrected and best spectacle-corrected visual acuity, and measure- ment of corneal HOAs. Lens fitting was performed in the next step. Finally, post-fitting measurements including contact lens–corrected visual acuity and corneal HOAs were performed. RESULTS: The root mean square of the total HOAs significantly decreased after fitting both miniscleral and hybrid lens designs. There was a significant change in the third-order vertical coma and spherical aberration after fitting the miniscleral lens. In the hybrid lens group, a significant change was found only in vertical coma after fitting. There was no significant difference in the post-fitting HOA change between the two groups. CONCLUSIONS: The results of this study showed the effectiveness of both miniscleral and hybrid lenses in decreas- ing HOAs in keratoconus patients. No significant difference was observed between these two lenses in this regard. Optom Vis Sci 2020;97:749–753. doi:10.1097/OPX.0000000000001560 Copyright © 2020 American Academy of Optometry Author Affiliations: 1 Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran 2 Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran 3 Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran 4 Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 5 Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran *jafarzadehpour.e@iums.ac.ir Keratoconus is the most common primary corneal ectasia with an estimated prevalence of 54 in 100,000. 1–4 Because of causing irregular astigmatism and progressive visual distortion, keratoconus is visually debilitating, 5 and therefore, there is a need for high-level optometric care for visual rehabilitation. 6 Although spectacles may provide an acceptable visual acuity in early stages of keratoconus, contact lenses are considered the mainstay of visual correction in the keratoconus patients 7,8 and usually eliminate or defer the need for keratoplasty. 9 Corneal rigid gas-permeable contact lenses are currently the most common type of contact lens modality for keratoconus. 10,11 Despite the widespread use and high success rate of corneal rigid gas-permeable lenses, their use is associated with some challenges, especially in more advanced stages of keratoconus, including suboptimal initial comfort and lens decentration (especially for inferiorly displaced cones). 12 However, recent advances in the design and material of contact lenses, including scleral and hybrid lenses, have improved fitting options for keratoconus patients. 10 With a larger diameter compared with corneal rigid gas-permeable lenses, scleral lenses vault the cornea and the limbus completely and rest on the sclera, resulting in improved comfort and stability. 13 Hybrid lenses comprise a center-zone rigid lens circumferentially attached to a peripheral soft skirt. Therefore, the aim of the hybrid design is to benefit from the properties of both hard and soft lenses (visual performance of hard lenses and comfort and stability of soft lenses). 14 Despite the availability and clinical use of these specialty lenses (scleral and hybrid lenses), there is limited literature address- ing their visual performance. 10 Moreover, the majority of the con- ducted studies are retrospective and nonrandomized. Furthermore, ORIGINAL INVESTIGATION www.optvissci.com Optom Vis Sci 2020; Vol 97(9) 749 Copyright © American Academy of Optometry. Unauthorized reproduction of this article is prohibited.