Impact of a three-month period of mini-scleral lens usage on intraocular pressure and the anterior chamber angle in patients with keratoconusOA

●AIM:To investigate the long-term effects of mini-scleral lens wear on intraocular pressure(IOP)and anterior chamber angle(ACA)in patients with keratoconus(KCN).●METHODS:A convenience sampling method was adopted to enroll KCN patients between November 2023 and April 2024.All participants had a definitive KCN diagnosis and were eligible for mini-scleral lens fitting.Baseline optometric examinations included visual acuity measurement,objective and subjective refraction,and slitlamp biomicroscopy.Mini-scleral lenses were fitted with trial lenses.Participants returned for a 3-month follow-up,where all examinations were repeated.●RESULTS:Seventeen KCN patients(12 males)were enrolled,aged 20–53y with a mean age of 38.09±12.86y.Mean IOP rose by 0.33±1.60 mm Hg after mini-scleral lens wear,without statistical significance(P=0.525).The nasal ACA increased by 0.73°±2.69°(P=0.390),whereas the temporal ACA decreased by−1.46°±3.10°(P=0.152).In severe KCN cases,mean IOP elevated from 7.60±0.96 to 8.60±1.14 mm Hg after lens fitting.By contrast,mild-tomoderate KCN patients showed a slight IOP decline from 11.58±2.50 mm Hg at baseline to 11.33±2.42 mm Hg post-fitting.Females presented a statistically significant reduction in temporal ACA after lens wear(P=0.020).Older baseline age was negatively correlated with temporal ACA width(β=−0.719,P=0.041).●CONCLUSION:Patients with advanced KCN face higher risks of IOP elevation after mini-scleral lens fitting.ACA changes induced by mini-scleral lenses vary by sector,with temporal angle narrowing being more prominent.Clinicians should closely monitor potential temporal angle narrowing,especially in female and older KCN patients during miniscleral lens fitting.