Effectiveness Of Wavefront-Guided Contact Lenses In Correcting Higher-Order Aberrations And Visual Acuity In Corneal Ectasia: A Systematic Review And Meta-Analysis
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR399 | Type: Free paper | DOI: 10.82333/kqky-yx78
Authors: Marwan Tahoun* 1 , A/Prof. Shehzad Naroo 2
1Warrington and Halton Hospitals NHS Foundation Trust,Warrington Hospital,United Kingdom, 2University of Aston,Aston,United Kingdom
Purpose
Purpose
The purpose of this study was to evaluate the effectiveness of wavefront-guided (WFG) contact lenses in improving visual acuity and reducing higher-order aberrations (HOAs) in individuals with corneal ectasia compared to conventional spherocylindrical corrections.
Setting
The review synthesized data from clinical studies and research laboratories that transitioned wavefront technology into clinical practice, focusing on patients with conditions such as keratoconus, pellucid marginal degeneration (PMD), and post-surgical ectasia.
Methods
A systematic review and meta-analysis were conducted according to PRISMA guidelines across five electronic databases (PubMed, Embase, CENTRAL, Web of Science) through November 2025. Inclusion criteria encompassed primary data on patients using wavefront-guided or profilometry-guided lenses. Quantitative synthesis utilized a random-effects model to calculate mean differences (MD) for Best Corrected Visual Acuity (BCVA) in logMAR and Higher-Order Root Mean Square (HO-RMS) aberrations.
Results
Fifteen studies comprising 172 eyes were included. Meta-analysis (n=144) showed a statistically significant improvement in BCVA favoring WFG scleral lenses (wfgSL) over traditional scleral lenses (MD: -0.12 logMAR; 95% CI: -0.21 to -0.03; p=0.03). A separate meta-analysis (n=160) demonstrated a significant reduction in HO-RMS (MD: -0.46 μm; 95% CI: -0.84 to -0.07; p=0.03). Qualitatively, rigid platforms outperformed soft lenses due to better rotational stability. Subjective outcomes were high, with 94% of patients in one study preferring WFG optics over traditional designs.
Conclusions
Wavefront-guided scleral lenses significantly reduce visually degrading aberrations and provide superior visual acuity compared to traditional optics. While the technology can approach physiological visual limits, neural adaptation to chronic blur represents a "bottleneck" that may limit immediate gains, requiring longer wear times for full functional recovery.