Use All Available Options for Keratoconus Patients

During the 2026 Global Specialty Lens Symposium, Susan Gromacki, OD, MS, gave a lecture titled “Keratoconus Lens Fitting Before and After Surgery.”

By
Deborah Fisher
January 1, 2026
2 min

Contact Lens Spectrum

Overview

Dr. Susan Gromacki emphasized the importance of utilizing a broad range of specialty contact lenses for keratoconus patients, especially given the increasing variety of corneal shapes post-surgery. She highlighted the need to tailor lens selection to both corneal and scleral anatomy as well as patient lifestyle.

Background

Keratoconus is a progressive corneal disorder causing irregular astigmatism and visual impairment. Traditional spectacles and soft contact lenses often fail to provide adequate vision correction for these patients. Specialty contact lenses remain the cornerstone of management, particularly for irregular corneas. Advances in surgical techniques such as PKP, DALK, cross-linking, and various ring segment implants have introduced more complex corneal shapes, necessitating a wider array of lens fitting options.

Data Highlights

Dr. Gromacki discussed multiple surgical interventions affecting corneal shape, including penetrating keratoplasty (PKP), deep anterior lamellar keratoplasty (DALK), cross-linking, conductive keratoplasty (CK), intrastromal corneal ring segments (Intacs), corneal allogenic intrastromal ring segments (CAIRS), and corneal tissue addition keratoplasty (CTAK). These procedures create diverse corneal and scleral profiles requiring customized lens fitting strategies.

Key Findings

Specialty contact lenses are essential for managing irregular corneas in keratoconus patients.
Post-surgical corneal shapes are increasingly diverse due to multiple surgical options.
Lenses must be selected based on both corneal and scleral anatomy.
Patient lifestyle considerations are critical in lens selection.
A wide array of lens options allows for individualized fitting to optimize vision and comfort.

Clinical Implications

Clinicians should be familiar with the expanding range of surgical procedures and their impact on corneal shape when fitting lenses for keratoconus patients. A personalized approach considering anatomical variations and patient lifestyle will improve visual outcomes and patient satisfaction. Utilizing all available lens options maximizes the potential for successful rehabilitation.

Conclusion

The management of keratoconus requires a comprehensive approach that integrates advanced surgical interventions with a broad spectrum of specialty contact lenses tailored to individual patient needs. This strategy enhances visual rehabilitation and quality of life for keratoconus patients.