Visual and therapeutic outcomes of mini scleral contact lenses in corneal and ocular surface disorders

Abstract

The objectives of the study are to evaluate the clinical indications, visual outcomes, and therapeutic efficacy of mini-scleral contact lenses (SCLs) in patients with corneal irregularities and ocular surface disorders at a tertiary eye care center. A retrospective analysis was conducted on 68 patients (85 eyes) fitted with mini SCLs at a tertiary eye care hospital between January 2022 and December 2024. Mean follow-up was 13 ± 3 months. Data reviewed included demographics, diagnosis, pre- and post-fitting best-corrected visual acuity (BCVA), wearing time, tolerance, and complications. Statistical analysis was performed using the Statistical Package for the Social Sciences version 25.0 with paired t -tests and Wilcoxon signed-rank tests; p < 0.05 was considered statistically significant. The majority of patients were male (68%), with the highest prevalence in the 21–30-year age group (34%). Indications included keratoconus (49.4%), post-penetrating keratoplasty (16.1%), post-deep anterior lamellar keratoplasty (post-DALK) (9.3%), corneal degenerations (6.4%), post-radial keratotomy (post-RK) (11.8%), Stevens–Johnson syndrome (2.9%), and post-refractive surgery ectasia (5.9%). Mean logarithm of the minimum angle of resolution BCVA improved significantly from 0.59 ± 0.32 to 0.24 ± 0.19 ( p < 0.01). Significant subgroup improvements were noted in keratoconus ( p < 0.01), post-DALK ( p = 0.041), corneal degenerations ( p = 0.041), and post-RK ( p = 0.026). Mean follow-up was 13 ± 3 months. No major complications were observed. Mini-scleral lenses are highly effective for visual rehabilitation in corneal ectasia and post-surgical irregularities and provide therapeutic benefits in ocular surface disorders. They represent an essential non- surgical rehabilitative modality in modern anterior segment practice.