Impact of rigid contact lens use on visual acuity and vision-related quality of life in keratoconus

Abstract

Purpose: To evaluate the relationship between visual acuity (VA) improvement and vision-related quality of life in patients with keratoconus using rigid gas-permeable (RGP) and scleral contact lenses (CLs). Methods: This observational study was designed as a cross-sectional study with retrospective collection of pre–contact lens clinical data. The best-corrected visual acuity (BCVA) before and after CL use was recorded. Pre–contact lens BCVA values were obtained retrospectively from medical records, which may introduce potential documentation bias. After CL usage, vision-related quality of life and CL adaptation were assessed using a validated Turkish version of the National Eye Institute Visual Function Questionnaire (VFQ-25) and a study-specific questionnaire developed by the investigators to explore practical aspects of contact lens use such as handling, adaptation, comfort, and concerns related to long-term use. The correlations between BCVA improvement and questionnaire responses were analyzed statistically. Results: A total of 26 patients (mean age 39.7 ± 13.6 years) were included. Mean BCVA improved significantly from 0.21 ± 0.20 to 0.83 ± 0.16 with contact lenses (p = 0.001). The VA improvement showed significant positive correlations with perceived visual improvement (p = 0.032) and vision-related quality-of-life enhancement (p = 0.007). These associations should be interpreted cautiously given the relatively small sample size and exploratory nature of the correlation analyses. The patients continued to express concerns regarding the long-term use of CL, despite the observed improvement in VA. Conclusion: The rigid contact lens use was associated with improvements in both visual acuity and vision-related quality of life in keratoconus. However, due to the limited sample size and cross-sectional design, the findings should be considered preliminary and interpreted as exploratory observations that may inform future prospective studies.