The greater utilization of soft contact lenses calls for the development of new and objective methods of evaluating the optical performance of the different lens types, in situ. We used videokeratography to examine the surface topography of soft contact lenses that had been worn for more than 1 year on 27 eyes of 23 patients, and compared the resulting color-coded maps and topographic indices as well as contact lens-corrected visual acuities, with those obtained with new replacement lenses on the same eyes. Visual inspection of the color-coded maps revealed differences in the surface characteristics of the used and new lenses. Comparison of quantitative indices including the SAI (Surface Asymmetry Index), IAI (Irregular Astigmatism Index), SRI (Surface Regularity Index), and SDP (Standard Deviation of Powers) showed that asymmetry, surface irregularity, potential visual acuity (derived from the SRI), and corneal power distribution were significantly poorer with the used lenses than with the new (P = 0.0001). The videokeratoscope is useful for evaluating the soft contact lens surface in situ, as an indicator of optical quality; it also permits the objective evaluation of lens cleaning techniques.