Correction of moderate to high refractive astigmatism with extended range toric soft contact lenses in patients with different patterns of astigmatism

Abstract Purpose This study aimed to evaluate the visual performance of extended range, toric soft contact lenses (TSCLs) in patients with keratoconus and moderate to high astigmatism with different astigmatic patterns. Methods This was a retrospective, cross‐sectional clinical study. Extended range TSCL users with astigmatism ≥3.0 D were included. Cases were categorised into three subgroups, namely regular, irregular (non‐keratoconus) and keratoconic based on the topographic pattern of astigmatism. In addition, subjects were subdivided based on the degree of astigmatism. Results Fifty five patients (82 eyes) were enrolled, of whom 28 (51%) were female. The mean age was 24.2 ± 7.5 (range: 8–41 years) years. Thirty‐six eyes with regular astigmatism (43.9%), 34 eyes with irregular astigmatism (41.5%) and 12 eyes with keratoconus (14.6%) were included. The percentage improvement in visual acuity (VA) was significantly higher with contact lenses compared with spectacles in all groups ( p  < 0.001), with the highest improvement in subjects with keratoconus ( p  = 0.03). Twenty six (31.7%), 30 (36.6%) and 26 eyes (31.7%) had moderate (−3.0 to −4.24 D), moderate/high (−4.25 to −5.99 D) and high (≤−6.0 D) astigmatism, respectively. The percentage improvement in VA with contact lenses was statistically significantly higher than for spectacle wear in all groups ( p  < 0.001). Conclusions This study demonstrated that satisfactory visual outcomes can be obtained with extended range TSCLs in patients having moderate to high astigmatism with different astigmatic patterns.