Editorial: Keratoconus and contact lenses

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Author
DSc* MSc* FCOptom FAAO Wolfgang Cagnolati1
1*Pennsylvania College of Optometry at Salus University, Eye- and Vision Center Optometrie Cagnolati GmbH

In 1888, the French ophthalmologist Photinos Panas presented two case reports of keratoconus patients who were successfully treated with "contact shells" designed by the Parisian ophthalmologist Eugène Kalt.1,2 Along with Adolf Eugen Fick and August Müller, Eugène Kalt is one of the inventors of the contact lens. Without knowing Fick's doctoral thesis "Eine Contactbrille", which was submitted for publication in September 1887 and published in 1888, Kalt was the first to deal with the optical correction of keratoconus, which was hardly treatable in the 19th century, by using "glass shells" with a diameter of between 16 mm and 22 mm, whose radius of curvature corresponded to the curvature of the cornea.1,2,3  In his publication "Kalt, Keratoconus,and Contact Lens", the British optometrist Richard M. Pearson describes in detail the life of Kalt in the context of keratoconus treatment. 110 years later, today's Association of German Contact Lens Specialists and Optometrists (VDCO) celebrated the 100th birthday of the contact lens on the occasion of its 34th scientific conference from September 22 to September 25, 1988 in the congress center of the Messe am Killesberg in Stuttgart, and keratoconus had its presence there as well. At the meeting, for example, the well-known Austrian ophthalmologist Bruno Miller lectured on "Contact lens fitting in advanced keratoconus," and contact lens specialist Peter Künzel led the seminar "Basics of contact lens fitting in keratoconus." Despite surgical options in the treatment of keratoconus, such as UV crosslinking with riboflavin, optical rehabilitation of keratoconus is still the primary treatment method in the presence of this corneal ectasia 134 years after Panas' case reports. New contact lens geometries and materials combined with new possibilities in determining corneal topography have made optical rehabilitation of keratoconus and other corneal ectasias safer today. However, this still requires a constant update of knowledge. The present OCL attempts to meet this need with three current related publications. The topics are:

  • Biomechanics of the cornea in keratoconus and other corneal ectasias 
  • Refitting of rigid gaspermeable contact lenses for keratoconus to improve wearing comfort
  • Contact lens treatment for visual rehabilitation in advanced keratoconus and after “MyoRing” implantation

But also the " Effect of phospholipid-containing eye drops on the de-wetting behaviour of soft contact lenses" has a high clinical relevance for daily practice, which is why we are pleased to present this publication to our readers as well.

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List of references

[1] Pearson, R. M. (1989). Kalt, Keratoconus, and Contact Lens. Optom. Vis. Sc., 69, 643-646.

[2] Brachner, A. (1988). Hundert Jahre Kontaktlinse – Vom Lesestein zur Kontaktlinse. Vereinigung Deutscher Contactlinsenspezialisten, Wenschow- Franzis, München.

[3] Kalt, E. (1888). Traítement optique du cératocone; in: Ann. d’oculistíque, Juni,p. 293fff.