title: Objective and subjective evaluation of the performance of medical contact lenses fitted using a contact lens selection algorithm.
abstract: OBJECTIVE
  To evaluate the performance of medical contact lenses (CLs) for a wide range of clinical indications.
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  A total of 281 eyes were evaluated in 281 consecutive patients (≥18 years of age; CL use ≥3 months) who visited the contact lens service in a tertiary academic clinic for a scheduled follow-up visit. The main outcome measured were clinical indications for CL wear; CL type; change in corrected distance visual acuity (CDVA) with CL use; CL wearing duration; CL wearing time; subjective performance measured using a visual analog scale (VAS) questionnaire (score range: 0-100); and effectiveness of the lens-selection algorithm.
  
  
  RESULTS
  Wearing CLs significantly improved CDVA compared to wearing spectacles (median change: -0.15 logMAR, range: 1.00 to -2.10; P<.001). Daily-wear CLs were worn by 77% of patients for a median of 15h/day (range: 5-18h/day), median 7 days/week (range: 1-7 days/week). High subjective scores were measured, with similar results obtained between the scleral lens and soft lens groups. The medical CL fitting was found to be generally effective (the overall satisfaction rating was ≥70 for 81% of patients).
  
  
  CONCLUSIONS
  Fitting CLs based on the lens-selection algorithm yielded positive clinical results, including improved visual acuity, satisfactory wearing time, and high overall subjective performance. Moreover, subjective performance was similar between users of scleral lenses and users of soft lenses. These results underscore the importance of prescribing scleral lenses and the need for tertiary eye clinics to offer patients a variety of CL types.
authors.affiliation: Visser Contact Lens Practice, Department of Ophthalmology, University Medical Center Utrecht, Room L.02.628, Postbus 85500, 3508 GA Utrecht, The Netherlands. Electronic address: esvisser@vissercontactlenzen.nl.
authors.forename: Esther-Simone
authors.initials: ES
authors.lastname: Visser
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Robert P L
authors.initials: RP
authors.lastname: Wisse
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: Soeters
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Saskia M
authors.initials: SM
authors.lastname: Imhof
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands; Department of Ophthalmology, Central Military Hospital Utrecht, Postbus 90000, 3509 AA Utrecht, The Netherlands.
authors.forename: Allegonda
authors.initials: A
authors.lastname: Van der Lelij
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003261:Contact Lenses; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008875:Middle Aged; D017755:Prosthesis Fitting / Q000379:methods*; D012030:Refractive Errors / Q000150:complications / Q000628:therapy*; D015203:Reproducibility of Results; D012590:Sclera; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000517:prevention & control*; D014792:Visual Acuity; D055815:Young Adult
keywords: Dry eye disease; Keratoconus; Keratoplasty; Lens selection algorithm; Medical contact lenses; Scleral lenses