角巩膜镜对圆锥角膜患者视力和角膜参数的影响

Effect of corneoscleral lenses on visual acuity and corneal parameters in patients with keratoconus

摘要:

目的：探讨配戴角巩膜接触镜对圆锥角膜患者视力和角膜参数的影响。

方法：前瞻性研究。共纳入43例(83眼)圆锥角膜患者。配戴角巩膜接触镜，并分别在戴镜前、戴镜3、6 mo后行裂隙灯检查、客观验光和主观验光、裸眼视力(UCVA)和最佳矫正视力(BCVA)、角膜曲率(Kmax、K1和K2)、中央角膜厚度和内皮细胞计数检查。

结果：配戴6 mo框架眼镜后平均BCVA(LogMAR)为0.34±0.23，角巩膜接触镜为0.03±0.05(P<0.001)。戴镜6 mo后，Kmax由52.80±5.93 D变为51.51±5.64 D(P<0.001)，角膜中央厚度由483.84±34.69 μm变为476.28±35.38 μm(P<0.001)，角膜中央细胞计数由2559.18±275.7 cells/mm²变为2572.73±274.3 cells/mm²(P<0.001)。

结论：临床中角膜参数未发生明显变化，角巩膜镜可显著提高视力，且可安全用于圆锥角膜患者。

Abstract:

AIM:To investigate the effect of wearing corneoscleral contact lens on visual acuity, and corneal parameters in keratoconus patients.

METHODS:In this prospective study, 43 cases(83 eyes)with keratoconus were included and examined. A corneoscleral contact lens was fitted, and thorough exams were carried out at baseline, 3 and 6 mo after wearing lenses, including slit lamp examination, objective and subjective refraction, uncorrected visual acuity(UCVA), and best-corrected visual acuity(BCVA), keratometry(Kmax, K1 and K2), central corneal thickness and endothelial cells count.

RESULTS: Mean BCVA(LogMAR)improved from 0.34±0.23 with the spectacles to 0.03±0.05 with the corneoscleral contact lenses in 6 mo(P<0.001). Kmax changed from 52.80±5.93 D to 51.51±5.64 D in 6 mo(P<0.001), central corneal thickness changed from 483.84±34.69 μm to 476.28±35.38 μm(P<0.001), and endothelial cell count changed from 2559.18±275.7 cells/mm² to 2572.73±274.3 cells/mm² after wearing corneoscleral contact lens for 6 mo(P<0.001).

CONCLUSION: Corneoscleral lenses could significantly increase visual acuity, since there were no clinical noticeable changes in the corneal parameters, this lenses can be used safely in patients with keratoconus.