Efficacy of mini-scleral lenses in visual rehabilitation for corneal disorders: a prospective study

Corneal irregularities are a significant cause of visual impairment, impacting patients' quality of life. Conventional treatment with spectacles and/or contact lenses fail to provide adequate rehabilitation in these cases. This study aimed to evaluate the efficacy and patient satisfaction with use of mini-scleral devices (MSDs) in patients with various corneal disorders including keratoconus, corneal scarring, post-corneal transplant, and post-refractive surgery.

This analytical, observational, prospective study included 40 eyes of 32 patients with corneal surface irregularities and rigid gas permeable (RGP) or soft contact lenses intolerance. Comprehensive ophthalmic evaluation, including corneal topography, was performed. Primary outcomes measured were improvement in best lens-corrected visual acuity (BLCVA) by ≥ 2 lines and daily wear time of ≥ 10 h. Secondary outcomes included patient comfort, lens acceptance, and adverse events. Patients were followed up for a duration of three months.

MSDs significantly improved visual outcomes, with 80% of eyes achieving a BLCVA of ≥ 0.4 logMAR. Patients with keratoconus (85%) and post-refractive surgery status (100%) exhibited best visual improvement. The mean daily wear time was 12.1 ± 2.2 h. High comfort levels were reported in 26 eyes, while 12.5% of patients discontinued using the MSDs. No significant adverse events were observed.

MSDs represent a valuable therapeutic option offering improved visual outcomes, high levels of patient satisfaction and comfort in patients with various corneal disorders. These are a good alternative for eyes not amenable to correction with glasses or contact lenses, especially in patients planned for or awaiting corneal transplant.