Correction of moderate to high refractive astigmatism with extended range toric soft contact lenses in patients with different patterns of astigmatism.

Purpose: This study aimed to evaluate the visual performance of extended range, toric soft contact lenses (TSCLs) in patients with keratoconus and moderate to high astigmatism with different astigmatic patterns.

Methods: This was a retrospective, cross-sectional clinical study. Extended range TSCL users with astigmatism ≥3.0 D were included. Cases were categorised into three subgroups, namely regular, irregular (non-keratoconus) and keratoconic based on the topographic pattern of astigmatism. In addition, subjects were subdivided based on the degree of astigmatism.

Results: Fifty five patients (82 eyes) were enrolled, of whom 28 (51%) were female. The mean age was 24.2 ± 7.5 (range: 8-41 years) years. Thirty-six eyes with regular astigmatism (43.9%), 34 eyes with irregular astigmatism (41.5%) and 12 eyes with keratoconus (14.6%) were included. The percentage improvement in visual acuity (VA) was significantly higher with contact lenses compared with spectacles in all groups (p < 0.001), with the highest improvement in subjects with keratoconus (p = 0.03). Twenty six (31.7%), 30 (36.6%) and 26 eyes (31.7%) had moderate (-3.0 to -4.24 D), moderate/high (-4.25 to -5.99 D) and high (≤-6.0 D) astigmatism, respectively. The percentage improvement in VA with contact lenses was statistically significantly higher than for spectacle wear in all groups (p < 0.001).

Conclusions: This study demonstrated that satisfactory visual outcomes can be obtained with extended range TSCLs in patients having moderate to high astigmatism with different astigmatic patterns.