Wavefront-Guided Scleral Lenses Show Promise for Correcting Higher-Order Aberrations in Keratoconus

January 12, 2026 – New data suggests that wavefront-guided gas-permeable scleral lenses, specifically Zenlens Chroma HOA from Bausch + Lomb, significantly improve vision correction for patients with keratoconus by addressing higher-order aberrations (HOAs). The findings, presented at the Global Specialty Lens Symposium, indicate these lenses may even defer or eliminate the need for corneal surgery in advanced cases.

Understanding Higher-Order Aberrations and Keratoconus

Keratoconus is a progressive eye disease where the cornea thins and gradually bulges outward, resulting in distorted vision. This irregular shape often leads to significant higher-order aberrations – imperfections in the way light focuses on the retina. These aberrations, such as coma and spherical aberrations, contribute to blurred vision, glare, and halos, even with traditional corrective lenses.

Zenlens Chroma HOA: A New Approach to Correction

Traditional gas-permeable lenses correct lower-order aberrations like nearsightedness and astigmatism. Zenlens Chroma HOA lenses go a step further by incorporating wavefront technology to customize the lens surface and correct higher-order aberrations. This customization is based on mapping the unique irregularities of each patient’s cornea.

Study Findings: Significant Improvements in Aberration Correction

A study conducted at Atwater Eye Care Center at Indiana University analyzed 15 eyes with keratoconus. Each eye was fitted with both a traditional gas-permeable lens and a Zenlens Chroma HOA lens. The results demonstrated substantial improvements in HOA correction with the wavefront-guided lenses:

• Vertical coma reduction: 74.9%
• Horizontal coma reduction: 78.6%
• Spherical aberration reduction: 75.8%

According to Jason Jedlicka, OD, FAAO, FSLS, clinical professor and chief of cornea and contact lens service at Indiana University School of Optometry, “Every patient in the group improved noticeably and significantly.” He emphasized that selecting patients with specific, severe aberrations yields the best outcomes.

Potential to Delay or Avoid Corneal Surgery

The significant vision improvements achieved with Zenlens Chroma HOA lenses may offer a valuable alternative for patients who might otherwise require corneal surgery, such as corneal cross-linking or transplantation. Dr. Jedlicka noted that these lenses “can improve vision enough to defer or permanently delay corneal surgery in more advanced cases.”

The Evolving Standard of Care

The research suggests a shift in the standard of care for keratoconus. Wavefront-guided gas-permeable lenses are becoming increasingly attainable, and practitioners should strive to achieve optimal vision correction for their patients. “It should no longer be acceptable for us as practitioners to settle for 20/30 or 20/40 vision for those patients when they could do better,” Dr. Jedlicka stated.

Source and Disclosures

Source: Jedlicka J. Correction of higher order aberrations in patients with keratoconus using a custom wavefront-guided scleral lens system. Presented at: Global Specialty Lens Symposium; Jan. 7-10, 2026; Las Vegas.

Disclosures: Dr. Jedlicka reports receiving honoraria from Bausch + Lomb.