Visual outcomes of scleral lenses in different stages and cone locations of keratoconus: A retrospective observational study

This study aims to evaluate the visual performance of scleral contact lenses (SCLs) in patients with keratoconus based on disease stage and cone localization and provide data to inform clinical practice. This retrospective study included 95 eyes from 61 keratoconus patients (34 females and 27 males) who underwent corneal cross-linking and were regularly followed at a single center between December 2019 and December 2023. Patients were categorized according to keratoconus stage (mild, moderate, or advanced) and cone localization (central, paracentral, or inferior) based on corneal topography. Visual acuity was recorded before and after mini SCL fitting, as were corneal topography and anterior segment parameters. Statistical analyses included the Wilcoxon signed-rank test, Mann-Whitney U test, and Kruskal-Wallis test for group comparisons, with Spearman correlation analysis used to assess associations between parameters. The mean patient age was 23.7 ± 7.1 years. Among the eyes evaluated, 44% had mild, 36% moderate, and 20% advanced keratoconus; cone localization was inferior in 56%, central in 34%, and paracentral in 10%. Mean logMAR visual acuity improved significantly from 0.95 ± 0.54 before SCL fitting to 0.14 ± 0.13 after application (P