Mini-scleral contact lens for management of poor visual outcomes after intrastromal corneal ring segments implantation in keratoconus

Purpose: to evaluate the feasibility and efficacy of mini-scleral design (msd) contact lenses to treat keratoconus patients who were unsatisfied with the results of corneal inlay. methods: in this prospective interventional case series,9 eyes of 6 keratoconus patients who were unsatisfied with the results of corneal inlay were fitted with msd contact lenses. demographic data,uncorrected visual acuity (ucva),best spectacle-corrected visual acuity (bscva),and higher order aberrations (hoas) were evaluated before contact lens fitting. corrected visual acuity by placing the msd contact lens with or without over-refraction,and hoas were measured one hour after contact lens fitting. one month after contact lens wearing,corrected visual acuity by placing the msd contact lens with over-refraction and possible contact lens related problems were assessed. ocular comfort and contact lens handling problems were asked in follow-up visits. the data was analyzed using descriptive statistical tests. results: nine eyes of 6 patients were successfully fitted with the mini-scleral lens. fitting was ideal in 7 eyes and acceptable in 2 eyes. mean corrected visual acuity by placing the msd lens without over-refraction was 0.09 (range,0.00-0.15) logmar which was significantly better than the mean bscva of 0.38 (range,0.2-0.6) logmar (p = 0.007). the mean root mean square (rms) of third-order coma and trefoil significantly decreased after msd contact lens fitting (p = 0.012 and p = 0.015,respectively); however,changes in the fourth-order spherical aberration were not statistically significant (p = 0.336). conclusion: mini-scleral contact lenses may be helpful in the management of visually unsatisfied patients after corneal inlay. © 2016 journal of ophthalmic and vision research.