Abstract： Objective To investigate the therapeutic efficiency of vitamin A palmitate eye gel on dry eye in keratoconus wearing rigid gas permeable contact lens (RGP).Methods Ninety cases of dry eye related to wearing RGP in keratoconus were randomly divided into 3 groups,each group of 30 cases (60 eyes):group A used artificial tear eye drop,1 drop each time,6 times on first; group B used vitamin A palmitate eye gel,1 drop each time,3 times on first; group C used artificial tear eye drop first and used vitamin A palmitate eye gel 15 minutes later.All cases had been detected and evaluated by subjective symptoms of dry eye,break-up time (BUT),Schirmer Ⅰ test (SⅠT) and corneal fluorescent staining (Fl),at pre-therapy and 3,7,14 days of post-therapy.Results The subjective symptoms of dry eye,FI and BUT of three groups had been more improved at 7 days after therapy than pre-therapy (P ＜0.05).SⅠT of three groups hadn't significant difference after therapy (P ＞0.05).The each index when measured on day 7 and day 14 had no significant difference in patients of each group (P ＞0.05).There was no significant difference in subjective symptoms,BUT and SIT between group A and group B (P ＞0.05),except Fl (P ＜0.05).Group C in improving the subjective symptoms of dry eye,BUT,and Fl stain was better than group A (P ＜0.05).SⅠT and Fl compared pre and post therapy had no significant difference between group B and group C (P ＞0.05).But in improving the subjective symptoms of dry eye and BUT,group C was superior to group B (P ＜0.05).Conclusions Vitamin A palmitate can promote the repair of corneal epithelial defects and significantly improve dry eye patients' symptoms and signs in keratoconus wearing RGP,so it has clinical application value.