The use of contact lenses for treating keratoconus was evaluated retrospectively for a 20-year period. Contact lenses—soft, hard, or piggyback—were successfully fit in 95% of the patients. Overall, 81% of the patients achieved 20/40 or better visual acuity. Additionally, 73% of the patients maintained stable vision within two lines of their initial visual acuity. Our results indicate that contact lenses should be the initial treatment of choice for keratoconus, and that, with proper lens fitting, most patients can achieve better than 20/40 visual acuity. Still, an occasional patient will require penetrating keratopiasty due to contact lens intolerance, corneal thinning or scarring, or poor visual acuity.
© 1987 The Contact Lens Association of Ophthalmologists, Inc.