Take a look at this guy:
https://laserfitlens.com/
I did this ~18 months ago. It's expensive, and you have to spend a week or more in a tiny town in Texas, but - It's by far the best comfort and vision I've had since being diagnosed with keratoconus.
It's a non rotational custom scleral lens that is CNC'd by a company local to their office in Coppell. The first day you get a bunch of measurements taken, then on day two you have the first set of lenses to try. You get a new set of lenses each day with the refinements from the previous day's appointment and leave with your final real set.
Back then it was about $4,000 with additional cost if time beyond a week was needed. I cut mine fairly short and did M-F, ideally I should probably have been there a couple more days. They don't take insurance, but you may be able to get some trivial amount of reimbursement from your insurance. I got about $300 back. The lenses themselves are not terribly expensive once you've had them designed, if you want a spare set or break one it's $250/ea and deliverable via mail. They have a deal with a local hotel that gives a stupid cheap nightly rate + shuttle service to and from your appointments so you don't need a rental car. His customer base is almost entirely KC + dry eye patients, so you're pretty much his average patient.
Care of the lenses is annoying, but worth the vision. I try to use Menicon Progent on them weekly, otherwise it's Clear Care daily. You'll need to use scleral lens cases which are much larger than the provided ClearCare sterilization case, so you go through Clear Care solution MUCH faster than a normal lens. The little travel bottles are good for about two days worth of use for me. Any time I travel I ship full size bottles ahead or take them in my checked bags. I routinely wear them for 15+ hours with no issues. My night vision is dramatically better than anything anyone else was able to obtain (both via soft/hybrid lenses and glasses).
Well worth it if you can pull off the $4k.
Viper GTS