title: New web-based algorithm to improve rigid gas permeable contact lens fitting in keratoconus.
abstract: OBJECTIVE
  To calculate and validate a new web-based algorithm for selecting the back optic zone radius (BOZR) of spherical gas permeable (GP) lens in keratoconus eyes.
  
  
  METHODS
  A retrospective calculation (n=35; multiple regression analysis) and a posterior prospective validation (new sample of 50 keratoconus eyes) of a new algorithm to select the BOZR of spherical KAKC design GP lenses (Conoptica) in keratoconus were conducted. BOZR calculated with the new algorithm, manufacturer guidelines and APEX software were compared with the BOZR that was finally prescribed. Number of diagnostic lenses, ordered lenses and visits to achieve optimal fitting were recorded and compared those obtained for a control group [50 healthy eyes fitted with spherical GP (BIAS design; Conoptica)].
  
  
  RESULTS
  The new algorithm highly correlated with the final BOZR fitted (r2=0.825, p<0.001). BOZR of the first diagnostic lens using the new algorithm demonstrated lower difference with the final BOZR prescribed (-0.01±0.12mm, p=0.65; 58% difference≤0.05mm) than with the manufacturer guidelines (+0.12±0.22mm, p<0.001; 26% difference≤0.05mm) and APEX software (-0.14±0.16mm, p=0.001; 34% difference≤0.05mm). Close numbers of diagnostic lens (1.6±0.8, 1.3±0.5; p=0.02), ordered lens (1.4±0.6, 1.1±0.3; P<0.001), and visits (3.4±0.7, 3.2±0.4; p=0.08) were required to fit keratoconus and healthy eyes, respectively.
  
  
  CONCLUSIONS
  This new algorithm (free access at www.calculens.com) improves spherical KAKC GP fitting in keratoconus and can reduce the practitioner and patient chair time to achieve a final acceptable fit in keratoconus. This algorithm reduces differences between keratoconus GP fitting (KAKC design) and standard GP (BIAS design) lenses fitting in healthy eyes.
authors.affiliation: Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Paseo de Belén, 7 - Campus Miguel Delibes, 47011 Valladolid, Spain; Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, 47011 Valladolid, Spain; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Ortiz-Toquero
authors.affiliation: Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Paseo de Belén, 7 - Campus Miguel Delibes, 47011 Valladolid, Spain; Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, 47011 Valladolid, Spain; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Rodriguez
authors.affiliation: Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, 47011 Valladolid, Spain; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain; Department of Ophthalmology, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: de Juan
authors.affiliation: Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Paseo de Belén, 7 - Campus Miguel Delibes, 47011 Valladolid, Spain; Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, 47011 Valladolid, Spain; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain; Faculty of Health and Human Sciences, Plymouth University, Derriford Road, PL6 8BH Plymouth, United Kingdom. Electronic address: raul@ioba.med.uva.es.
authors.forename: Raul
authors.initials: R
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D003261:Contact Lenses; D003315:Cornea / Q000473:pathology; D019781:Corneal Topography; D004867:Equipment Design; D005260:Female; D006801:Humans; D020407:Internet; D007640:Keratoconus / Q000175:diagnosis / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012029:Refraction, Ocular; D012189:Retrospective Studies; D055815:Young Adult
keywords: Algorithm; Contact lens; Gas permeable; Keratoconus