ESCRS - POCOR325 - Early Use Of Miniscleral Lens After Corneal Collagen Cross-Linking (Cxl) In Keratoconus: A Prospective Comparative Study

Early Use Of Miniscleral Lens After Corneal Collagen Cross-Linking (Cxl) In Keratoconus: A Prospective Comparative Study

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR325 | Type: Free paper | DOI: 10.82333/r3sz-b795

Authors: Dr Shahnaz Anjum* 1 , Dr Shivam Garg 1 , Prof. Rajesh Sinha 1

1Dr Rajendra Prasad Centre for Ophthalmic Sciences,All India Institute of Medical Sciences (AIIMS),New Delhi,India

Purpose

To evaluate whether early use of mini-scleral lenses (MSL) after corneal collagen cross-linking (CXL) affects
corneal remodeling or facilitates faster visual rehabilitation in moderate-to-advanced keratoconus.

Setting

This was a prospective non-randomised comparative case series conducted at Dr Rajendra Prasad Centre for
Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, from December 2021 to November
2024.

Methods

This prospective comparative study included 30 eyes of 30 keratoconus patients divided into two groups: CXL-
only (n = 15) and CXL + early-MSL (n = 15). Accelerated CXL (9 mW/cm2 for 10 minutes) was performed in all eyes. In
the MSL group, lenses (Keracare, Acculens, USA) were fitted three to four weeks after confirmation of complete epithelial
healing. Outcomes included uncorrected (UCVA) and best lens-corrected visual acuity (BLCVA), refraction, keratometry
(K1, K2, Kmax), pachymetry, corneal densitometry, and aberrometry, measured at baseline, one, three, and six months.

Results

Both groups showed comparable reductions in mean K1, K2, and Kmax values and similar changes in thinnest
pachymetry over six months (p > 0.05), indicating no difference in corneal remodeling between groups. Corneal
densitometry decreased gradually in both cohorts, reflecting normal stromal recovery. UCVA improved significantly in
both groups (CXL: 0.84 → 0.75 logMAR, p = 0.0493; MSL: 0.68 → 0.53 logMAR, p = 0.0363). The MSL group achieved
greater improvement in BLCVA (0.18 → 0.05 logMAR, p = 0.0004), demonstrating faster functional visual rehabilitation.
No epithelial, infectious, or inflammatory complications occurred.

Conclusions

Early fitting of MSL three to four weeks after CXL is safe, does not affect corneal biomechanics or
transparency, and enables faster visual recovery compared with CXL alone. Larger randomized studies are warranted to
confirm these findings.