Systematic review investigating the time taken for corneal stabilisation following contact lens cessation

Contact lenses (CLs), used by approximately 140 million people globally, can induce corneal warpage, altering corneal geometry. This impacts corneal imaging, influencing diagnostic assessments, follow-ups and pre-operative evaluations. This systematic review aimed to determine the optimal CL cessation period before corneal imaging. A systematic literature search was conducted across multiple databases. Studies were included if they assessed corneal stabilisation post-CL cessation by using corneal imaging techniques. Quality was rated using the modified Downs and Black checklist. Fifteen studies met the inclusion criteria; 13 prospective observational studies, one retrospective and one observational case series. Five of these studies included a control group. Following the removal of CLs, the included studies reported stabilisation of corneal parameters as follows: for soft CLs, 2-11.6 weeks (median 2.1 weeks); for hard CLs, 1-22 weeks (median 7.6 weeks); for orthokeratology lenses, 1-2 weeks (median 1.6 weeks) and for tinted lenses, 2-3 hours. Factors influencing stabilisation included lens material, water content, wear modality, CL fit and patient age. Two studies were found to be of excellent methodological quality, 11 were assessed as good and two as fair. No studies were found to be of poor quality. Corneal stabilisation time post-CL cessation was variable and dependent on the lens type and fit, patient age and method of determining corneal stabilisation. Personalised recommendations and standardised assessments are essential for optimising diagnostic and surgical outcomes. Further research is needed to develop comprehensive guidelines for consistent CL removal protocols. CRD42023484401.