Effectiveness and risk of contact lenses in mild pediatric keratoconus
Keywords:
pediatric keratoconus; rigid gas permeable contact lenses; myopia; astigmatism; keratometryAbstract
Introduction: The optical correction of pediatric keratoconus in its early stages presents a challenge, where the selection of the method is influenced by clinical factors and sociocultural influences that impact its acceptance, treatment adherence and visual development.
Objective: To evaluate the effectiveness and risk of contact lenses in mild pediatric keratoconus.
Methods: A quasi-experimental study was conducted between October 2012 and September 2024 at the Ophthalmology Center of Ciego de Ávila, involving a sample of 406 eyes from 212 pediatric patients with keratoconus, divided into three groups: experimental corrected with hydrophilic contact lenses, experimental with rigid gas-permeable contact lenses, and control (with glasses). Paired sample mean comparison tests were applied. The risk of keratoconus progression was estimated, and the effectiveness of the correction methods was determined.
Results: A significant improvement in best-corrected visual acuity, refractive variables, and keratometric values was observed in all three groups, with no significant differences between them. However, the experimental group with rigid gas-permeable contact lenses showed a relative risk of keratoconus progression of 2,6. The control group achieved the highest effectiveness at 82,5% and the lowest progression rate (17,5%).
Conclusions: best-corrected visual acuity is independent of the optical correction method in the initial stages of pediatric keratoconus, although glasses proved to be the method of choice in these patients, because of their higher effectiveness and lower ectatic progression.
Downloads
References
1. Gupta Y, Saxena R, Jhanji V, Maharana PK, Sinha R, Agarwal T, et al. Management Outcomes in Pediatric Keratoconus: Childhood Keratoconus Study. J Ophthalmol [Internet]. 2022 [Citado 12 ene 2025];4021288:8. Disponible en: https://doi.org/10.1155/2022/4021288
2. Taşcı YY, Saraç Ö, Çağıl N, Yeşilırmak N. Comparison of Hybrid Contact Lenses and Rigid Gas-Permeable Contact Lenses in Moderate and Advanced Keratoconus. Turk J Ophthalmol [Internet]. 2023 [Citado 12 feb 2025];53(3):142-8. Disponible en: https://doi.org/10.4274/tjo.galenos.2022.82754
3. Santodomingo-Rubido J, Carracedo G, Suzaki A, Villa-Collar C, Vincent SJ, Wolffsohn JS. Keratoconus: An updated review. Cont Lens Anterior Eye [Internet]. 2022 [Citado 14 dic 2024];45(3):101559. Disponible en: https://doi.org/10.1016/j.clae.2021.101559
4. Marta A, Marques JH, Almeida D, José D, Barbosa I. Keratoconus and Visual Performance with Different Contact Lenses. Clin Ophthalmol [Internet]. 2021 [Citado 18 feb 2025];2021(15):4697-4705. Disponible en: https://doi.org/10.2147/OPTH.S345154
5. Scanzera AC, Deeley M, Joslin C, McMahon TT, Shorter E. Contact Lens Prescribing Trends for Keratoconus at an Academic Medical Center: Increased Utilization of Scleral Lenses for Severe Disease. Eye Contact Lens [Internet]. 2022 [Citado 10 dic 2024];48(2):58-62. Disponible en: https://doi.org/10.1097/ICL.0000000000000869
6. Şengör T, Aydın Kurna S. Update on Contact Lens Treatment of Keratoconus. Turk J Ophthalmol [Internet]. 2020 [Citado 19 feb 2025];50:234-44. Disponible en: https://doi.org/10.4274/tjo.galenos.2020.70481
7. Anitha V, Vanathi M, Raghavan A, Rajaraman R, Ravindran M, Tandon R. Pediatric keratoconus - Current perspectives and clinical challenges. Indian J Ophthalmol [Internet]. 2021 [Citado 11/05/2025];69:214-25. Disponible en: https://doi.org/10.4103/ijo.ijo_1263_20
8. Song M, Chen T, Moktar A, Chan E, Chong EW, Daniell M, et al. Diagnosis and Management of Keratoconus A Narrative Review of Clinicians’ Perspectives. Children [Internet]. 2022 [Citado 06 feb 2025];9:1973. Disponible en: https://doi.org/10.3390/children9121973
9. Yilmaz T, Yilmaz A, Altin F, Ozcelik F. Effects of rigid high gas-permeable contact lens wear on progression in patient with keratoconus. Turk J Vasc Surg [Internet]. 2022 [Citado 14 mar 2025];11(4):1630-4. Disponible en: https://doi.org/10.5455/medscience.2022.09.205
10. Castro-Cárdenas K, Zayas-Ribalta Y, Mayea-Díaz DY, Martínez-Cereijo L, Roque-Morgado M, Molina-Verona RA, et al. Prevención y tratamiento de la ambliopía refractiva en el queratocono pediátrico. Rev haban cienc méd [Internet]. 2022 [Citado 20 oct 2025];22(4):e5485 Disponible en: http://revhabanera.sld.cu/index.php/rhab/article/view/5485
11. Castro Cárdenas K, Mayea Díaz DY, Zayas Ribalta Y, Fernández Cuevas A. Aspectos a considerar para el diagnóstico del queratocono infantil. MEDISAN [Internet]. 2024 [Citado 02 abr 2025];28(2):e3942. Disponible en: https://medisan.sld.cu/index.php/san/article/view/3942
12. Mahmoud S, El-Massry A, Bahgat Goweida M, Ahmed I. Pediatric keratoconus in a tertiary eye center in Alexandria: a cross-sectional study. Ophthalmic Epidemiol [Internet]. 2021 [Citado 06 feb 2025];29(1):49-56. Disponible en: https://doi.org/10.1080/09286586.2021.1892154
13. Yekta A, Hashemi H, Ostadimoghaddam H, Hadizadeh M, Rafati S, Doostdar A, et al. Anterior and posterior corneal higher-order aberrations in early diagnosis and grading of keratoconus. Clin Exp Optom [Internet]. 2023 [Citado 18 feb 2026];106(3):263-70. Disponible en: https://doi.org/10.1080/08164622.2022.2033602
14. Moreno Ramírez ME, Brizuela Concepción Y, Sánchez Gómez DR. Lentes de contacto rígidas. En: Cárdenas Díaz T, editor. Óptica y Optometría. Principios y aplicación clínica. Vol. 2. La Habana: ECIMED; 2023. p. 545-56. Disponible en: http://www.bvscuba.sld.cu/libro/optica-y-optometria-principios-y-aplicacion-clinica-volumen-2/
15. Tsung-Hsien T, Jui-Hung H, Chi-Chin S, Ching-Hsi H, Jiahn-Shing L, Ken-Kuo L. Effect of apical clearance rigid corneal contact lens fitting on keratoconus progression: a controlled longitudinal analysis. Cont Lens Anterior Eye [Internet]. 2025 [Citado 19 may 2026];48(6):102449. Disponible en: https://doi.org/10.1016/j.clae.2025.102449
16. Zahra Dashti R, Shehzad AN, Firouze H, Saeid A, Mohammad-Rabei H, Masoud M, et al. The impact of contact lenses on binocular vision in patients with keratoconus. J Optom [Internet]. 2026 [Citado 19 may 2026];19(3):100610. Disponible en: https://doi.org/10.1016/j.optom.2026.100610
17. Jareño Ochoa M, León Rodríguez Y, Hernández Fernández Y, Castillo Borges YM, Mayea Díaz DY, Saavedra Rodríguez LL. Efectividad y seguridad del entrecruzamiento corneal en pacientes con queratocono progresivo a largo plazo. Rev haban cienc méd [Internet]. 2024 [Citado 08 ene 2026];23:e5669. Disponible en: https://revhabanera.sld.cu/index.php/rhab/article/view/5669
18. World Medical Association. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA [Internet]. 2025 [Citado 11 feb 2026];333(1):71-4. Disponible en: https://doi.org/10.1001/jama.2024.21972
19. Tharini B, Sahebjada S, Borrone MA, Vaddavalli P, Ali H, Reddy JC. Keratoconus in pre-teen children: Demographics and clinical profile. Indian J Ophthalmol [Internet]. 2022 Oct [Citado 11 jun 2025];70(10):3508-13. Disponible en: https://doi.org/10.4103/ijo.IJO_2579_21
20. Sahin S, Palamar M, Egrilmez S, Yagci A, Selver OB. Comparison of Corneal Tomography Parameters in the Diagnosis of Keratoconus in Early and Late Pediatric Age Group. Middle East Afr J Ophthalmol [Internet]. 2024 Dec 2 [Citado 22 jun 2025];30(4):241-5. Disponible en: https://doi.org/10.4103/meajo.meajo_105_23
21. Meyer JJ, Gokul A, Vellara HR, et al. Progression of keratoconus in children and adolescents. Br J Ophthalmol [Internet]. 2023 [Citado 09 jun 2025];107:176-80. Disponible en: https://doi.org/10.1136/bjophthalmol-2020-316481
22. Alhazmi A, Alsomali A, Algarni S, Althumairi A. Pediatric keratoconus in a tertiary eye hospital in Eastern province, Saudi Arabia: Patient characteristics and management outcomes. Saudi J Ophthalmol [Internet]. 2024 [Citado 22 jun 2025];38(3):261-7. Disponible en: https://doi.org/10.4103/sjopt.sjopt_169_24
23. Deshmukh R, Ong ZZ, Rampat R, Alió del Barrio JL, Barua A, Ang M, et al. Management of keratoconus: an updated review. Front. Med [Internet]. 2023 [Citado 10 ene 2026];10:1212314. Disponible en: https://doi.org/10.3389/fmed.2023.1212314
24. Gal E, Gispets J, Zyroff M, Netanya E, Gantz L. Assessment of large-diameter and small-diameter SoftK specialty contact lenses for early-stage keratoconus. Ophthalmic Physiol Opt [Internet]. 2024 [Citado 14 dic 2025];44:884-93. Disponible en: https://doi.org/10.1111/opo.13331
25. Swartz G, Alam K, Gentle A, Downie LE. Impact of contact lens correction on wavefront aberrations and vision quality in keratoconus. Ophthalmic Physiol Opt [Internet]. 2025 [Citado 08 ene 2026];45:1811-28. Disponible en: https://doi.org/10.1111/opo.70037
26. Larrosa M, Lupón N, Gispets J, Cardona J. A novel large diameter rigid gas-permeable corneal contact lens design for keratoconus. J Optom [Internet]. 2025 [Citado 13 ene 2026];18(2):100547. Disponible en: https://doi.org/10.1016/j.optom.2025.100547
27. Iqbal M, Gad A, Kotb A, Abdelhalim M. Analysis of the outcomes of three different cross-linking protocols for treatment of paediatric keratoconus: A multicentre randomized controlled trial. Acta Ophthalmol [Internet]. 2024 Feb [Citado 17 may 2025];102(1):e105-e16. Disponible en: https://doi.org/10.1111/aos.15686
28. Niazi S, Jiménez-García M, Findl O, Gatzioufas Z, Doroodgar F, Shahriari MH, Javadi MA. Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review. Diagnostics [Internet]. 2023 Aug [Citado 17 may 2025];13(16):2715. Disponible en: https://doi.org/10.3390/diagnostics13162715
29. Rashid ZA, Mashige KP, Moodley VR. Validity of keratoconus screening tests. Clin Exp Optom [Internet]. 2025 Jul [Citado 4 dic 2025]:1-10. Disponible en: https://doi.org/10.1080/08164622.2025.2530535
30. Akiyama K, Ono T, Ishii H, Chen LW, Kitamoto K, Toyono T, et al. Impact of rigid gas-permeable contact lens on keratometric indices and corneal thickness of keratoconus eyes examined with anterior segment optical coherence tomography. PLoS One [Internet]. 2022 [Citado 07 nov 2025];17(7):e0270519. Disponible en: https://doi.org/10.1371/journal.pone.0270519
31. Loh IP, Sherwin T. Is Keratoconus an Inflammatory Disease? The Implication of Inflammatory Pathways. Ocul Immunol Inflamm [Internet]. 2022 Jan [Citado 11 nov 2025];30(1):246-55. Disponible en: https://doi.org/10.1080/09273948.2020.1780271
32. Xu Y, Wang Y, Zhang XF. Effects of rigid gas permeable contact lens on morphological parameters and vision-related quality of life in keratoconus patients. Int J Ophthalmol [Internet]. 2022 [Citado 16 dic 2024];15(11):1772-81. Disponible en: https://doi.org/10.18240/ijo.2022.11.07
33. Das P, Mitra S, Tati V, Sahu SK, Basu S, Shukla S. Comparative Analysis of Inflammatory Mediators in Children, Adolescents, and Adults with Vernal Keratoconjunctivitis. Semin Ophthalmol [Internet]. 2026 Jan [Citado 1 abr 2026];11:1-9. Disponible en: https://doi.org/10.1080/08820538.2025.2612542
34. Thuangtong A, Phongsuphan T. Success Rates and Prognostic Factors in the Management of Keratoconus: A 10-Year Retrospective Cohort Study at Siriraj Hospital. Siriraj Med J [Internet]. 2024 [Citado 9 dic 2025];76:822-30. Disponible en: https://doi.org/10.33192/smj.v76i12.269895
35. Gomes JA P, Tan D, Rapuano CJ, Belin MW, Ambrósio R, Guell JL, et al. Global Consensus on Keratoconus and Ectatic Diseases. Cornea [Internet]. 2015 [Citado 19 nov 2024];34(4):359-69. Disponible en: https://doi.org/10.1097/ICO.0000000000000408
36. Barba-Gallardo LF, Jaramillo-Trejos LM, Agudelo-Guevara AM, Galicia-Durán AP, Casillas-Casillas E. Binocular vision parameters and visual performance in bilateral keratoconus corrected with spectacles versus rigid gas-permeable contact lenses. J Optom [Internet]. 2024 [Citado 22 jul 2025];17(3):100514. Disponible en: https://doi.org/10.1016/j.optom.2024.100514
37. Ministerio de Justicia. Listado de precios de medicamentos, óptica y auditivos. Resolución 345/2020 (GOC-2020-944-O81). Gaceta oficial de la República de Cuba [Internet]. 2020 Dic [Citado 19 may 2026];81:1820-2. Disponible en: https://www.gacetaoficial.gob.cu/sites/default/files/goc-2020.ex81pdf_0.pdf
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Karyna Castro Cárdenas, Yaney Zayas Ribalta, Maikel Roque Morgado, Linette Martínez Cereijo, Aliuska Fernández Cuevas, María Eufemia Padrón Pereira, Inés de la Caridad Esteban Amas
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The journal Anales de la Academia de Ciencias de Cuba protects copyright, and operates with a Creative Commons License 4.0 (Creative Commons Attribution-NonCommercial License 4.0). By publishing in it, authors allow themselves to copy, reproduce, distribute, publicly communicate their work and generate derivative works, as long as the original author is cited and acknowledged. They do not allow, however, the use of the original work for commercial or lucrative purposes.
The authors authorize the publication of their writings, retaining the authorship rights, and assigning and transferring to the magazine all the rights protected by the intellectual property laws that govern in Cuba, which imply editing to disseminate the work.
Authors may establish additional agreements for the non-exclusive distribution of the version of the work published in the journal (for example, placing it in an institutional repository or publishing it in a book), with recognition of having been first published in this journal.
To learn more, see https://creativecommons.org
