Visual quality with corneo-scleral contact lenses for keratoconus management

•Visual quality was assessed in 27 eyes fitted with a corneo-scleral contact lens for the management of keratoconus.•The total high order aberrations decreased by approximately 55% and contrast sensitivity improved to normal range values of the population.•In addition, prolonged wearing times with no adverse effects on the cornea were observed.•These contact lenses seem to be safe and healthy, providing an alternative option for keratoconus management. To assess the visual quality achieved by fitting corneo-scleral contact lenses (CScL) for keratoconus management. Thirty patients with keratoconus presented to have CScL fitted because of the unsatisfactory visual quality they experienced with their contact lenses or spectacles. The eye examination included visual acuity assessment, anterior eye biomicroscopy, ocular fundus examination, corneal topographic analysis, endothelial-cell count, contrast sensitivity and aberrometry. The fitting process was performed using a diagnostic trial set. Subjective visual quality and comfort, and contact lens wear time were also reported. Patients were monitored for one year. Three patients discontinued CScL wear before one year. Therefore, 27 eyes of 27 patients (19 male and 8 female) participated in this study. The mean age was 36.1 ± 13.1 (mean ± SD) years. Statistically significant differences were found in logMAR visual acuity between the best spectacle-corrected vision and after CScL fitting (mean ± SD, 0.23 ± 0.30 and 0.00 ± 0.14, respectively; p