配戴Orbiflex K®角膜接触镜改善圆锥角膜患者视力的研究

目的：评估圆锥角膜患者配戴Orbiflex K?角膜接触镜在不同疾病阶段的视力康复结果。
　　方法：选取研究对象为2012-11/2013-12在 Dr. Lütfi Kιrdar Kartal培训和研究医院确诊为圆锥角膜的52例患者80眼。所有患者接受硬性角膜接触镜治疗,术后随访12 mo。患者的平均年龄为26.1±6.9岁(范围：15~43岁)。患者依照Amsler-Krumeich分型以及各阶段角膜曲率值进行分组。在配戴角膜接触镜治疗前后进行裸眼视力( UCVA),最佳矫正视力( BCVA),主观验光,角膜形态,角膜曲率,中央角膜厚度和生物显微镜检查。
　　结果：角膜横轴屈光度(K1)平均值为50.25±4.17D,而角膜纵轴屈光度(K2)平均值为53.82±4.81D。 K的平均值为52.03±4.42 D。 UCVA的平均值为1.31±0.21 LogMAR ( Snellen 0.05±0.04),戴眼镜和戴角膜接触镜下BCVA的平均值分别为0.79±0.33 LogMAR(Snellen 0.21±0.17)和0.05±0.08 LogMAR(Snellen 0.91±0.13)。比较角膜接触镜治疗前后的视力结果,差异有统计学意义(P<0.001)。第1,2,3和4阶段圆锥角膜患者视力提高平均行数分别为5.18±1.38(范围：2~8)行,5.86±1.79(范围：2~8)行,6.32±2.16(范围：3~9)行和6.92±2.35(范围：3~9)行。
　　结论：OrbiflexK?角膜接触镜显著地改善了所有阶段的圆锥角膜患者的视力。     

Rose K RGP对圆锥角膜矫正视力影响的初步观察

目的:初步观察Rose K硬性透氧性角膜接触镜(Rose K RGP)对圆锥角膜矫正视力的影响。方法:为经角膜地形图确诊为圆锥角膜的12例20眼验配Rose K RGP。该组病例球镜屈光度范围-1.00～-21.50DS;柱镜屈光度范围-1.25～-8.75DC。排除配戴禁忌证,经RGP规范验配程序(高度数球镜患者采用快速睫状肌麻痹检影,次日复查屈光度)和Rose K RGP试戴片戴镜验光,确定RGP镜片参数。配发镜片后,教育戴镜者依照规范操作方法及程序配戴和护理镜片。随访时间5～14mo。我们采用自身前后对照方法进行最佳矫正视力的对比研究。结果:该组病例中14眼(70%)为三点接触配适形态,5眼(25%)为顶点离开的配适形态,1眼(5%)为可接受的顶点接触配适形态。全部病例均能通过配戴Rose K RGP获得较框架眼镜更好的矫正视力(平均框架视力0.6±0.03,平均RGP视力0.9±0.05)。随访期内无严重并发症发生。结论:在角膜地形图指导下,圆锥角膜患者验配Rose K RGP容易达到比较理想的配适形态,获得较满意的矫正视力,矫正效果理想。     

硬性透气性角膜接触镜矫正圆锥角膜疗效分析

目的 探讨硬性透气性角膜接触镜(RGP)矫正圆锥角膜的临床疗效及安全性.方法 对2004～2010年视光门诊应用RGP矫正的63例圆锥角膜患者,男41例,女22例.年龄16-35岁,平均年龄(24.6±7.81)岁.双眼57例,单眼6例.对散光度明显增大,框架眼镜矫正视力下降的患者应用电脑验光仪、角膜地形图仪、角膜内皮镜检测,筛查圆锥角膜病.对确诊及疑似圆锥角膜患者根据角膜圆锥程度采用普通RGP镜或特殊设计圆锥角膜镜进行矫正.测量RGP矫正视力及戴镜验光.应用SPSS13.0统计软件对框架眼镜矫正视力、RGP矫正视力、及配戴RGP前后球镜度、散光度进行统计学分析,P＜0.05为有统计学意义.结果 (1)本组病例框架眼镜矫正视力均值:0.56±0.29,RGP矫正视力均值:0.93±0.20,(t=-14.627,P=0.000),RGP矫正视力明显优于框架矫正视力.(2)配戴RGP前散光均值:(-4.16±2.19)DC,配戴RGP后散光均值:(-0.77±1.2)DC,(t=-14.585,P=0.000),配戴RGP散光度明显降低与配镜前比较差异显著有统计学意义.(3)其中22只眼平均观察3.5年,其中1只眼角膜混浊加重,施板层角膜移植术.其余21只眼角膜散光度降低,有统计学意义.角膜厚度、角膜曲率变化差异无统计学意义.结论 RGP矫正圆锥角膜不规则散光明显提高矫正视力,改善视觉质量,在一定程度上延缓圆锥角膜病的进展.     

硬性透气性接触镜对角膜散光和圆锥角膜矫正分析

目的 观察硬性透气性接触镜(RCPCL)对角膜散光和圆锥角膜矫正的疗效和安全性.方法 收集2004年9月到2008年10月在本中心验配RGPCL的患者50例(92只眼),观察分组:低度近视散光组、高度近视散光组、圆锥角膜组.将验配RGPCLL后的矫正视力与验配框架眼镜后的矫正视力比较.结果 低度近视散光组.配戴RGPCL和配戴框架眼镜后矫正视力≥0.8者分别为42只眼(88%)、38只眼(79%);高度近视散光组,配戴RG-PCL和配戴框架眼镜后矫正视力≥0.8者分别为31只眼(94%)、25只眼(76%);圆锥角膜组,配戴RGPCL和配戴框架眼镜后矫正视力≥0.8者分别为11只眼(84%)、2只眼(15%).90%的患者自觉舒适,可以坚持配戴.结论 高度近视散光、圆锥角膜忠者配戴高透氧性RCPCL矫正视力明显高于配戴框架镜患者.并有较好舒适度,视野较大,无明显并发症.     

硬性透气性角膜接触镜矫治屈光不正的临床观察

目的:观察硬性透气性角膜接触镜矫治屈光不正的效果、使用安全程度及舒适度.方法:对38例(76眼)来我院验配RGPCL的患者,根据其屈光度、角膜曲率和配适情况选择合适的镜片.定期观察其配戴RGPCL的矫正视力、适应性及舒适度.结果:配戴RGPCL可以获得良好的矫正视力,尤其对高度近视、散光及圆锥角膜的矫正效果明显优于框架眼镜(P=O.005).RGP镜片屈光度均低于框架眼镜屈光度.戴镜1mo后均感觉较为舒适,镜片中心位置及活动度好,未见有严重角结膜并发症.结论:RGPCL对屈光不正有良好的矫正效果,明显优于框架镜,且安全有效容易被接受.     

透气硬性角膜接触镜在角膜屈光手术后的应用

目的 观察透气硬性角膜接触镜(Rigid Gas-permeableContactlenses,RGP)在角膜屈光手术后矫正视力、改善视觉症状的效果.方法 眼科视光门诊中做过近视性角膜屈光手术的患者7例1 1只眼,经常规检查后,予验配多种设计的RGP,记录戴镜前的裸眼视力、框架镜最佳矫正视力和戴RGP的最佳矫正视力.记录部分患者戴RGP前后的波前像差.随访过程中记录配戴情况及并发症.结果 该组患者需要三种设计的RGP镜片:圆锥角膜RGP、逆几何RGP和大直径非球面RGP.戴RGP前裸眼视力在0.03～0.4者7只眼,0.8～1.0者4只眼.戴RGP前的框架镜最佳矫正视力在0.2～0.5者5只眼,0.7～1.0者6只眼.戴RGP的最佳矫正视力在0.7～0.9者4只眼,1.0者7只眼.配戴RGP后的球差、彗差和三叶草差分别较配戴前降低88.7%、92.9%和18.9%.全部患者的视觉症状在配戴RGP后均改善.角膜上皮染色是最常见的并发症,主要是圆锥角膜的锥顶部上皮磨损染色.平均随访21.5月,全部患者能够坚持日间配戴.结论 角膜屈光手术后配戴特殊设计的RGP可以提高视力,改善视觉质量.未见严重地角膜接触镜相关的并发症.

Abstract：

Objective To evaluate the efficacy of specially designed rigid gas-permeable contact lenses (RGP) in visual correction and visual symptom control after corneal refractive surgery. Methods Eleven eyes of 7 cases after myopic corneal refractive surgery from optometry clinic were fitted with RGP in different designs after routine eye checks. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA) before RGP fitting and best contact lens corrected visual acuity (BCLCVA) after RGP fitting were recorded. Wave front aberrations of some patients before and after RGP fitting were measured. Fitting state and complications were recorded at follow-ups. Results Three kinds of lens design were applied: keratoconic design, reverse geometry design and aspheric design with larger diameter. BCLCVA was much higher than UCVA and BSCVA. Spherical aberration, coma and trefoil were reduced by 88.7%, 92.9% and 18.9% respectively after RGP fitting. Visual symptoms of all patients after RGP fitting were improved. The main complication was corneal staining of iatrogenic keratoconus. All patients can tolerate wearing RGP in the day time after an average follow-up of 21.5 months. Conclusions Specially designed RGP fitted after corneal refractive surgery can raise the best corrected visual acuity and improve the quality of vision. No serious complications related to RGPwearing are observed.     

Comfort-Kone硬性角膜接触镜矫治圆锥角膜

目的观察comfort-kone硬性角膜接触镜(rigid gas-permeable contact lens,RGPCL)控制圆锥角膜发展的效果。方法 52例(94眼)患者采用"三点接触法"配戴comfort-kone RGPCL,分析对比配戴后屈光度、角膜地形图参数及泪液情况的变化,评价RGPCL控制圆锥角膜发展的临床效果。结果配戴RGPCL后最佳矫正视力0.83±0.24,与配戴前最佳矫正视力0.58±0.35比较,差异有显著统计学意义(t=-8.87,P=0.00);RGPCL矫正视力与配戴眼屈光度和角膜曲率半径呈显著相关(P=0.001、0.000),与角膜散光度无显著相关性(P=0.081)。随访期间RGPCL矫正视力稳定,角膜健康状况良好;患者主观适应时间为(11.13±9.10)d;长期配戴后基础泪液分泌量显著降低,差异有显著统计学意义(t=2.867,P=0.007)。结论 Comfort-Kone RGPCL能够显著提高圆锥角膜患者的视觉质量,长时间配戴安全、稳定,有效地控制了圆锥角膜的持续发展。     

圆锥角膜患者验配RGP便捷方法探讨

目的 通过了解硬性高透气性角膜接触镜(rigid gas permeable corneal contact lens,RGP)度数(degree of rigid gas permeable corneal contact lens,RGPD)与主觉验光等效球镜度(spherical equivalent degree,SSED)之间关系,RGP最佳矫正视力(best corrected visual acuity of rigid gas permeable corneal contact lens,RGPVA)与裸眼视力(uncorrected visual acuity,UCVA)、主觉验光最佳矫正视力(best corrected visual acuity of subjective refraction,SBCVA)之间关系,探讨圆锥角膜患者验配RGP便捷方法,观察RGP矫治圆锥角膜患者的疗效、安全性、舒适度及并发症.方法 收集2011年7月至2015年5月我院圆锥角膜患者64例(102眼),记录UCVA、主觉验光结果及其SSED、RGPVA、RGPD及定期复查情况.为探讨RGPD、RGPVA与SSED、SBCVA间大小及关系,分别把圆锥角膜102眼作为一组(A)及以散光度数2.0 CD、3.0 CD、4.0 CD、5.0 CD、6.0 CD为界分别把102眼分为两组,即(B1、B2)、(C1、C2)、(D1、D2)、(E1、E2)、(F1、F2)来研究.结果 相关性分析:除F2组外,其他各组RGPD与SSED均呈正相关(均为P＜0.01);除E2、F2组外,其他各组RGPVA与SBCVA均呈正相关(均为P＜0.01);所有组RGPVA与UCVA间均无相关性(均为P＞0.01).差异分析:除D2、E2、F2组外,其他各组RGPD与SSED度数差异均无统计学意义(均为P＞0.05).所有组RGPVA较UCVA、SBCVA均有明显提高(均为P＜0.05).随访期间RGP配戴者无明显不适及严重并发症发生.结论 圆锥角膜患者其主觉验光度数和视力可为RGP验配提供重要参考,使RGP验配更快捷,但随着散光度数的增加,此参考价值减小.圆锥角膜患者配戴RGP后能达到更好的矫正视力,并有较高的舒适度和安全性.     

接触镜对101例圆锥角膜的矫正与治疗

目的：探讨透气性硬性接触镜（ＲＧＰＣＬ）对圆锥角膜眼的视力矫正与治疗效果。方法：观察１０１ 例圆锥角膜,选择配戴ＲＧＰＣＬ的病例,对其中角膜变形严重无法单独使用ＲＧＰＣＬ的７ 只眼采用了Ｐｉｇｇｙｂａｃｋ ｌｅｎｓ（软性接触镜与硬性接触镜的组合使用）。随访时间１～２４ 个月。结果：以轻、中度圆锥角膜为主,处方ＲＧＰＣＬ的基础曲率半径绝大多数大于７．３０ｍｍ ,度数小于－ ６．００Ｄ。ＲＧＰＣＬ矫正视力达１．０、１．２ 的占４８ ％ ,０．６ 以上的达８２％ ,明显优于框架眼镜。戴镜时间每日平均１３．５ 小时,无明显角结膜并发症出现。ＲＧＰＣＬ戴用后角膜散光度平均减少１．７０～２．２１Ｄ,近视度平均降低０．７５ ～２ ．１０Ｄ,角膜形状明显扁平化。Ｐｉｇｇｙｂａｃｋｌｅｎｓ 明显改善了配适状态,提高了矫正视力和舒适度。结论：ＲＧＰＣＬ对圆锥角膜的高度屈光不正矫正效果良好。在严密观察下,可对重症病例选择使用Ｐｉｇｇｙｂａｃｋｌｅｎｓ。     

硬性透气性角膜接触镜矫正圆锥角膜不规则散光后对比度视力的观察

目的 观察硬性透气性角膜接触镜（RGPCL）矫正圆锥角膜完成期患者不规则散光的临床效果.设计病例系列研究. 研究对象圆锥角膜完成期患者20例（22眼）. 方法采用多功能视力测量仪MFVA100分别测试20例（22眼）圆锥角膜患者裸眼（UCVA）、最佳框架矫正（BSCVA）和RGPCL矫正状态下100%、25%、10%和5%的4种对比度视力.角膜荧光染色法和相干光断层成像术（OCT）观察镜片下泪液的分布情况,判断RGPCL的静态配适状态.用单因素方差分析、LSD法两两比较相同对比度下3组视力之间的差别.主要指标对比度视力.结果 22眼在100%、25%、10%和5%对比度下平均UCVA分别为0.195、0.098、0.053、0.042（P均〈0.05）,平均BSCVA分别为0.421、0.205、0.116、0.064（P〈0.05）,平均RGPCL矫正视力分别为0.880、0.520、0.308、0.169（P均〈0.05）.在100%、25%、10%和5%四种对比度下RGPCL的矫正视力均优于UCVA和BSCVA（P均=0.000）,而在5%对比度下UCVA与BSCVA无显著差异（P=0.142）.22眼RGPCL矫正后荧光素染色裂隙灯钴蓝灯光下见呈稍平坦配适、大曲率子午线上泪液填充较多、边缘部泪液宽度适中.戴镜后用前节OCT扫描中央光学区角膜显示出大、小曲率子午线上镜片下泪液分布厚度不同.结论 RGPCL可矫正圆锥角膜完成期患者的不规则散光,明显提高圆锥角膜患者不同对比度下的矫正视力.     

A retrospective analysis of vision correction and safety in keratoconus patients wearing Toris K soft contact lenses

The purpose of this study was to investigate the efficacy and safety of the Toris K silicone hydrogel contact lens (SwissLens; Prilly, Switzerland) in keratoconus patients. A database with information on 50 keratoconus patients (64 eyes) fitted with Toris K soft contact lenses over a 2-year period was retrospectively reviewed. Demographic data, prefitting refraction, the reason for choosing the Toris K soft contact lens, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), best-corrected visual acuity with a rigid gas permeable lens (BCVA RGP), best-corrected visual acuity with the Toris K lens (BCVA Toris K), and complications were evaluated. The mean age ± standard deviation at the time of fitting was 27.92 ± 9.86 years. The mean spherical refractive power was ?4.62 ± 6.53 dioptres, and the mean cylinder was ?3.78 ± 2.43 dioptres. The most common reason for using Toris K soft contact lenses was an inability to fit the patient with a RGP contact lens. There was a statistically significant difference between UCVA and BCVA Toris K (p = 0.0001), as well as between BSCVA and BCVA Toris K (p = 0.0001). However, there was no statistically significant difference between BCVA Toris K and BCVA RGP (p = 0.20). Superficial punctate keratitis and giant papillary conjunctivitis were the most common complications. The Toris K contact lens is a viable alternative for the optical management of all grades of keratoconus. The Toris K soft contact lens is a promising alternative for the visual rehabilitation of keratoconus patients who cannot tolerate RGP lenses or achieve a good fit.     

Rose K contact lens fitting for keratoconus

Purpose We evaluated the clinical outcome and fitting characteristics with Rose K contact lenses in patients with irregular astigmatism due to keratoconus. Methods About 19 patients with keratoconus were fitted with Rose K lens in the Cornea Department at the Fatih Sultan Mehmet Training and Research Hospital between May 2005 and April 2006. Patients were between 19 and 32 years of age. All the patients underwent a complete ophthalmic examination and best-corrected visual acuity measurements were taken with glasses at the baseline visit. During biomicroscopic evaluation, position, and centralization of the contact lens and fluorescein staining were noted. Visual acuity, contact lens comfort, and daily contact lens wearing time after fitting were evaluated. Results A total of 96% of the patients tolerated the fitting. The mean daily wearing time was 10.7 h. There was a significant increase in visual acuity with Rose K lens compared with best-corrected spectacle visual acuity. Conclusion Rose K lenses are a viable alternative in the visual rehabilitation of patients with keratoconus. This study has been presented in the XXIV Congress of the ESCRS, September 9–14, 2006 London as a poster.     

The effect of the YK lens in keratoconus

Purpose: To report the clinical results of the use of the YK contact lens (Lucid Co., Seoul, Korea) for keratoconus. Methods: One hundred and twenty nine keratoconic eyes were fitted with a YK lens which has one base curve and three peripheral curves. A light feather touch fluorescein pattern was obtained based on topographic indices. Visual acuity, comfort, mean wearing time, and ocular tissue changes were evaluated. Mean follow up was 17.5 ± 13.8 months (range 6–75). Results: One hundred and twenty six (97.6%) eyes tolerated the contact lenses. A total of 94.5% of the eyes achieved a visual acuity of 20/40 or better (average 0.79 ± 0.21), and flatter base curve radius (BCR) was related to better visual acuity. One hundred and seventeen (90.7%) eyes reported that the lenses were comfortable. Mean wearing time was 12.1 h per day (range 4–18). Changes in keratometric values were not significant between baseline and final follow‐up visit. Conclusions: The YK lens can provide successful visual outcome, with comfort, and no significant influence on the progression of keratoconus.     

巩膜镜矫正圆锥角膜的临床效果观察

目的：探讨临床上巩膜镜治疗圆锥角膜的有效性。方法：回顾性研究。选择2020 年10 月至2021 年3月于南京医科大学眼科医院验配巩膜镜的圆锥角膜患者18例（26眼）。根据圆锥角膜AmeslerKrumeich分级,I级9眼,II级3眼,III级4眼,IV级10眼。所有患者均经规范验配程序试戴硬性透气 性接触镜（RGPCL）,因RGPCL不耐受、RGPCL适配不佳等原因选择验配巩膜镜。所有患者均进行 视力、屈光度、裂隙灯显微镜、眼底和Pentacam检查等。应用巩膜镜试戴片试戴,分别通过裂隙灯 显微镜观察、荧光素染色及眼前节光学相干断层扫描（OCT）进行适配评估。评估镜片与中央角膜和 周边间隙,以及周边着陆区匹配情况,并评估戴镜后的最佳矫正视力（BCVA）及主观舒适度。采用 Friedman检验进行统计学分析。结果：所有圆锥角膜患者初戴巩膜镜时,裂隙灯显微镜观察示巩膜 镜定位良好。通过前节OCT观察初始角膜中央间隙为（212±58）μm;配戴巩膜镜4 h后,角膜中央间隙为 （164±58）μm,鼻侧为（101±38）μm,下方为（224±135）μm,颞侧为（103±72）μm,上方为（89±45）μm, 镜片边缘结膜血管未见异常。裸眼视力（UCVA）、框架眼镜BCVA、RGPCL配戴后BCVA及巩膜镜 配戴后BCVA（LogMAR）分别为1.35（1.00, 2.00）、0.52（0.22, 0.79）、0.15（0, 0.30）、0.10（0, 0.22）, 各视力差异有统计学意义（χ2 =67.11, P<0.001）。巩膜镜配戴后BCVA较UCVA、框架眼镜BCVA明显 改善,差异有统计学意义（χ2 =59.90, P<0.001; χ2 =31.08, P=0.001）;巩膜镜配戴后BCVA与RGPCL配 戴后BCVA差异无统计学意义（P=1.000）。配戴巩膜镜4 h后,22眼（22/26）主诉戴镜后舒适或非常舒 适;24眼（24/26）主诉戴镜视物良好或非常良好。结论：圆锥角膜配戴巩膜镜定位良好,舒适度也良 好,通过配戴巩膜镜可有效提升矫正视力。巩膜镜是圆锥角膜患者一种有效的治疗方式。     

Toric人工晶状体植入矫正老年性白内障合并角膜散光的疗效

目的：探讨老年性白内障合并角膜散光行超声乳化摘除联合Toric人工晶状体植入的临床效果,比较Acrysof Toric人工晶状体植入前后的视觉质量。

方法：选择老年性白内障合并角膜散光的患者34例为研究对象,进行白内障超声乳化摘除联合Toric人工晶状体植入,观察术前和术后3mo的临床效果,包括裸眼视力(UCVA),最佳矫正视力(BCVA),全眼残余散光,人工晶状体转动度数,视远脱镜情况。

结果：所有患者Toric人工晶状体均成功植入。术前UCVA 0.15±0.06,术后UCVA上升至0.65±0.15(P<0.01); 术前BCVA 0.37±0.13,术后BCVA上升至0.85±0.19(P<0.01); 全眼散光由术前2.14±0.69D降低至0.73±0.36D(P<0.01),97%的患者人工晶状体转位<5°,平均旋转2.6°±1.3°,术后3mo视远脱镜率达95%。

结论：Toric人工晶状体能够有效矫正白内障合并的角膜散光,晶状体在囊袋内具有良好的稳定性,提高了患者的术后视觉质量。     

稳定型圆锥角膜患者植入新型Phakic角膜接触镜的视觉效果分析

目的：评估可植入式Phakic角膜接触镜治疗稳定型圆锥角膜患者的疗效、安全性、稳定性和可预测性。

方法：共14例患者采用植入式Phakic角膜接触镜(IPCL)矫正屈光不正,测量了未矫正视力、最佳矫正视力、离焦曲线、对比敏感度、屈光度及可能的副作用。评估结果超过6mo。

结果：平均等效球镜度(SE)和散光在术后6mo末次检查时由术前-6.94±2.79 DS和-4.24±1.42 DC分别变为术后-0.23±0.43 DS和-1.05±0.49 DC。术前平均Snellen视力为0.18±0.10。6mo内未矫正视力和最佳矫正视力平均值分别为0.13±0.10和0.05±0.15。平均安全指数为1.11。所有眼视力均无降低,其中22眼视力提高超过1行。20眼(71.4%)屈光度在0.50 D以内,27眼(96.42%)在±1.00 D以内。术后1wk至6mo,屈光度变化为-0.23±0.43(范围： -1.00至+0.75)。6mo内角膜内皮细胞(ECL)丢失率小于5%。术后6mo眼压(IOP)为11.32±2.28 mmHg。

结论：Toric植入式Phakic角膜接触镜在矫正与稳定圆锥角膜相关的近视和近视散光方面具有有效性、安全性和可预测性。     

Scleral contact lenses for visual rehabilitation in keratoconus and irregular astigmatism after refractive surgery

This study aims to report our experience of using fluid-ventilated, gas-permeable scleral contact lenses (SCLs) for visual rehabilitation of patients with keratoconus and irregular astigmatism after refractive surgery. This is a noncomparative interventional case series reporting eight consecutive patients fitted with SCLs because of irregular astigmatism following the failure of other optical corrections. Retrospective chart review and data analysis included age, sex, etiology prior to lens fitting, visual outcomes, follow-up time, and complications. Twelve eyes of eight patients were studied. All eyes were fitted with SCLs due to unsatisfactory vision with spectacle correction or other contact lens modalities. Five eyes had keratoconus and seven had irregular corneas post refractive surgery. The mean follow-up period was 14.4 ± 1.3 months (range 11–17 months). The mean age was 32.63 ± 7.68 years (range 18–48 years). The average steepest keratometry(Kmax) of our series was 49.56 ± 12.2 D. The mean refractive astigmatism was 5.50 ± 5.3 D. The mean best corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution improved from 0.71 ± 0.50 (range 0.10–1.40) to 0.05 ± 0.07 (range 0.00–0.15) after SCL fitting (p < 0.001). All reported eyes achieved significant improvement in the BCVA with SCL fitting. None of the patients discontinued to wear SCLs. SCLs should be considered lenses of choice in irregular corneas refractory to conventional optical correction.     

单切口植入有晶状体眼后房型人工晶状体治疗高度近视

目的：评价单切口有晶状体眼后房型人工晶状体植入术治疗高度近视的有效性和安全性。

方法：对9例18眼高度近视患者行有晶状体眼后房型人工晶状体植入术。术后随访3～9mo,观察手术前后裸眼视力、最佳矫正视力、屈光度、散光变化、眼压、内皮细胞计数等。

结果：所有患者成功植入眼内接触镜(implantable contact lens,ICL),18眼手术前后平均屈光度分别为-13.38±-5.32,

-0.25±0.38D; 手术前后裸眼视力分别为0.06±0.04,0.6±0.2; 最佳矫正视力分别为0.5±0.3,0.7±0.3; 术后裸眼视力和最佳矫正视力均明显好于术前(P<0.05)。术前平均眼压为13.23±3.18mmHg,术后平均眼压为15.03±1.25mmHg; 内皮细胞计数术前为3 008±298个/mm²,术后为2 896±246个/mm²; 前房深度术前平均为3.56±0.29mm,术后为3.68±0.37mm,角膜散光术前0.52±0.30D,术后角膜散光0.67±0.45D,差异均无统计学意义(P>0.05)。

结论：单切口植入有晶状体眼后房型人工晶状体矫正高度近视近期临床效果有效、可靠,具有手术操作风险低、眼表损伤小、成本低、术源性散光小的优点,为一种适用的手术方式。     

Visual outcomes of a new implantable phakic contact lens in patients with stable keratoconus

AIM: To assess the efficacy, safety, stability and predictability of an implantable Phakic contact lens in patients with stable keratoconus. METHODS: The uncorrected and the best corrected visual acuity, defocus curve, contrast sensitivity, refraction and possible side effects were measured in 14 patients after utilizing implantable phakic contact lens (IPCL) to correct refractive errors. The result was assessed for more than 6mo. RESULTS: The mean preoperative spherical equivalent (SE) and astigmatism got changed from -6.94±2.79 DS and -4.24±1.42 DC to -0.23±0.43 DS and -1.05±0.49 DC, respectively at the last examination after 6mo. Before the preoperative the mean Snellen visual acuity was 0.18±0.10 logMAR. The mean uncorrected and the best corrected visual acuity got changed to 0.13±0.10 logMAR and 0.05±0.15 logMAR, respectively in 6mo. The mean safety indices were 1.11. There was no loss of visual acuity in any of the eyes and 22 eyes (78.5%) gained one or more lines. Twenty eyes (71.4%) were within 0.50 ?D and 27 (96.42%) were within ±1.00?D of the desired SE refraction. There was a change in manifest refraction of -0.23±0.43 (range from -1.00 to +0.75) from the first week of surgery to 6mo. Contrast sensitivity got improvement value at 3 per degree (P<0.005) after Toric IPCL implantation. The total 6mo corneal endothelial cell loss (ECL) was <5%. Intraocular pressure (IOP) was 11.32±2.28 mm Hg after 6mo. CONCLUSION: The clinical consequences of the present study exhibit the efficacy, safety, and predictability of Toric implantable Phakic contact lens in the correction of myopia and myopic astigmatism related with stable keratoconus.