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.”
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By
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Deborah Fisher
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January 1, 2026
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Clinical Scorecard: Use All Available Options for Keratoconus Patients
At a Glance
| Category | Detail |
|---|
| Condition | Keratoconus |
| Key Mechanisms | Irregular corneal shape causing visual impairment |
| Target Population | Patients with keratoconus, including post-surgical cases |
| Care Setting | Specialty contact lens fitting clinics and ophthalmology practices |
Key Highlights
- Specialty contact lenses are the mainstay treatment for irregular corneas in keratoconus.
- A wide variety of corneal shapes exist, especially after surgeries like PKP, DALK, cross-linking, and others.
- Lens selection must consider corneal and scleral shape as well as patient lifestyle.
Guideline-Based Recommendations
Diagnosis
- Assess corneal shape and irregularities, including post-surgical changes.
Management
- Utilize specialty contact lenses tailored to individual corneal and scleral anatomy.
- Consider all surgical history including PKP, DALK, cross-linking, CK, Intacs, CAIRS, and CTAK when planning lens fitting.
Monitoring & Follow-up
- Regular follow-up to evaluate lens fit and visual acuity.
- Monitor corneal health post lens fitting and surgery.
Risks
- Potential complications from improper lens fit due to complex corneal shapes.
- Risk of corneal damage if lenses are not appropriately selected or monitored.
Patient & Prescribing Data
Keratoconus patients with varying corneal shapes, including post-surgical cases
Lens choice should be individualized based on corneal and scleral anatomy and patient lifestyle to optimize vision and comfort.
Clinical Best Practices
- Evaluate the full range of available specialty lens options for each patient.
- Incorporate detailed corneal and scleral shape assessment into lens selection.
- Consider patient lifestyle factors when recommending lens types.
- Remain updated on surgical interventions and their impact on corneal shape.
References
