Clinical Outcomes of Mini-scleral Contact Lenses in Eyes with Keratoconus

ABSTRACT

Purpose@#To analyze the clinical results of fitting mini-scleral contact lenses prescribed for vision correction in eyes with keratoconus, and the parameters of eyes related to the base curve radius (BCR) of the final prescribed lenses. @*Methods@#From January 2016 to March 2021, 24 patients (44 eyes) who used mini-scleral lenses for more than 3 months due to keratoconus were enrolled. The keratoconus stage before prescription, degree of corrected visual acuity improvement, follow-up period, and complications and causes of failure to maintain the lenses were analyzed. The correlations between the BCR of the final prescribed lenses and the morphological factors of the eyes were analyzed. @*Results@#The average Amsler–Krumeich keratoconus stage before wearing a lens was 2.2 ± 0.8 and 90.9% of patients had a corrected visual acuity improvement exceeding 2 lines. Excluding four eyes in two patients (9.9%) who gave up wearing mini-scleral lenses, the average duration of wearing lenses was 23.6 ± 17.8 months, and the average daily wearing time was 8.79 ± 3.14 hours. Complications were conjunctival injection in five eyes (three patients) and sterile keratitis and superficial punctate keratitis in one eye, respectively. The causes of failure to maintain the mini-scleral lens were injection in two eyes (one patient) and handling difficulty in two eyes (one patient), and they gave up after an average of 6 months. Only the radii of the anterior and posterior corneal best fit sphere before wearing the lens were found to have a significant positive correlation with the BCR of the finally prescribed lenses (p < 0.001). @*Conclusions@#Mini-scleral lenses provide relatively good vision improvement without serious complications in patients at various stages of keratoconus, and the BCR of the finally prescribed lens had a good correlation with the anterior and posterior corneal best fit sphere.