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

Objectives: 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. Material and Methods: 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. Results: 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. Conclusion: 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.