The purpose of the study was to investigate the factors affecting long-term compliance with rigid gas-permeable contact lens (RGPCL) wear in patients with keratoconus (KC). A total of 189 patients with KC (374 eyes) were included in the study, and were divided into two groups: the compliant group and the non-compliant group. Corneal topographic measurements, refractive results, and RGPCL parameters were compared between the two groups. A vision-related quality of life questionnaire was completed by all of the patients. The results demonstrated that patients diagnosed with bilateral KC were more compliant with RGPCL wear than patients diagnosed with unilateral KC (p = 0.0167). There were no significant differences between the compliant and non-compliant groups in terms of their corneal topographic measurements, refractive results, RGPCL parameters, or corneal cross-linking surgery history (all p > 0.05). In contrast, KC patients' subjective experience with RGPCL wear-including visual acuity (p = 0.006), overall satisfaction (p < 0.001), quality of life (p < 0.001), and good adaptation during the short-term (p < 0.001)-had a significant effect on the long-term compliance with RGPCL wear. In conclusion, patients' subjective experiences, rather than their ocular biometrics, significantly influence their long-term compliance with RGPCL wear.
Keywords: compliance; corneal cross-linking; keratoconus; questionnaire; rigid gas-permeable contact lens.