{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:22:37Z","timestamp":1787588557817,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OVS"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study investigated the change in higher order aberrations (HOAs) and visual acuity with wavefront\u2010guided scleral lenses (WFGSLs) in the management of patients with keratoconus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 22 eyes from 13 patients with keratoconus were fit with WFGSLs utilizing a commercially available aberrometer to further reduce residual HOAs uncorrected via traditional scleral lenses (tSLs). The outcomes for total higher order root mean square (HORMS) and individual Zernike terms at various pupil sizes (maximal, 5\u00a0mm, 3\u00a0mm), best corrected visual acuity (BCVA), tomography, and subjective patient preference at the most recent visit, representing a minimum of 48\u00a0weeks of WFGSL adaptation, were compared to the prior traditional SLs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      WFGSLs resulted in significant reductions of HORMS and individual Zernike terms (Z7, Z8, Z11, Z17, and Z18) for all pupil sizes (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05 for all). When analyzing data from a 5\u00a0mm pupil, mean HORMS improved 53% (0.59\u00a0\u00b1\u00a00.30\u00a0\u03bcm vs. 0.28\u00a0\u00b1\u00a00.14\u00a0\u03bcm,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). BCVA was significantly improved by 2 Snellen lines (0.18\u00a0\u00b1\u00a00.16 vs. \u22120.040\u00a0\u00b1\u00a00.090 logMAR,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). All patients subjectively preferred WFGSLs over the traditional SLs. No adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>WFGSLs provide effective management for residual HOAs as evidenced by the significant reductions observed in HORMS and individual Zernike terms (Z7, Z8, Z11, Z17, and Z18) for various pupil sizes. Correspondingly, WFGSLs significantly improve BCVA and are preferred over traditional SLs by all patients in this cohort. Therefore, WFGSL provides a valid alternative vision rehabilitation solution to help diminish the need for surgery in keratoconus patients who do not achieve adequate visual outcomes via traditional SLs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ovs2.70092","type":"journal-article","created":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T03:25:59Z","timestamp":1786764359000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of wavefront\u2010guided scleral lenses in keratoconus patients"],"prefix":"10.1002","volume":"103","author":[{"given":"Omar H.","family":"Masoud","sequence":"first","affiliation":[{"name":"Wills Eye Hospital  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clark Y.","family":"Chang","sequence":"additional","affiliation":[{"name":"Wills Eye Hospital  Philadelphia Pennsylvania USA"},{"name":"EssilorLuxottica North America 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