RGPCL对圆锥角膜前表面形态的影响

目的观察RGPCL对圆锥角膜患者的视力及角膜前表面形态的影响。方法回顾性病例对照研究。Pentacam眼前节分析系统分期为KK2期的圆锥角膜眼,有效配戴RGPCL者22例（28眼）作为实验组,无效配戴RGPCL者8例（9眼）作为对照组,均为理想或可接受的三点接触的配适状态。观察配戴RGPCL 1年后的矫正视力及配戴前后角膜前表面形态学参数的变化。采用配对t检验进行数据分析。结果配戴RGPCL 1年后患者矫正视力提高,明显优于框架眼镜。与对照组相比,角膜前表面曲率平坦K值变化不大（P>0.05）,而陡峭K值明显变小（t=4.420,P<0.01）,角膜散光变小（t=4.271,P<0.01）,形态学参数中表面变异指数（ISV）、高度不对称性指数（IHA）变小（t=2.939,P<0.01;t=1.690,P<0.05）,最小曲率半径（Rmin）变大（t=2.315,P<0.05）,圆锥角膜指数（KI）、中央圆锥角膜指数（CKI）、IVA、高度离心指数（IHD）差异无统计学意义（P>0.05）。所有患眼随诊期都无严重并发症出现。结论配戴RGPCL对KK2期圆锥角膜眼不但可提高视力而且能改善病变区角膜形态,是目前非手术方法矫治圆锥角膜的安全有效方法。     

高透氧性硬性透气性角膜接触镜矫正高度与特殊类型屈光不正

目的观察高透氧性硬性透气性角膜接触镜（rigid gas permeable contact lens,RGPCL）矫正高度与特殊类型屈光不正的临床疗效及安全性。方法收集2004年7月-2006年11月验配高透氧性RGPCL的患者94例（154眼），观察各组（高度近视散光组，圆锥角膜组，特殊屈光不正组）验配RGPCL后的矫正视力，并与框架镜的矫正视力比较。通过患者的评分评估配戴舒适度及清晰度。定期复诊，观察有无眼部并发症的发生。结果高度近视散光组配戴RGPCL和配戴框架镜后视力≥4．9的分别为56眼（83．58％）、35眼（52．24％），圆锥角膜屈光不正组配戴RGPCL和配戴框架镜后视力≥4．9的分别为63眼（88．73％）、33眼（46．48％）；特殊类型屈光不正组配戴RGPCL和配戴框架镜后视力≥4．9的分别为11眼（68．75％）、10眼（62．50％）。配戴高透氧性RGPCL后舒适度评分为80-95，而戴原RGPCL的评分为60-85。戴镜1年后有4例出现结膜充血，1例角膜上皮擦伤。结论对于高度近视散光、圆锥角膜及各种原因引起的高度屈光不正，高透氧性RGPCL的矫正视力明显优于框架镜，并有较高的舒适度和安全性，无明显的并发症发生。     

RGPCL矫治圆锥角膜长期临床观察

目的观察RGPCL矫治圆锥角膜的长期临床应用效果。方法回顾性研究。以2005-2009年间在沈阳爱尔眼科医院视光中心因圆锥角膜验配RGPCL患者为研究对象,共260例（496眼）。男212例,女48例。所有患者随访观察时间至少4年。评估RGPCL镜片配适状态,对配戴框架眼镜和RGPCL的矫正视力,配戴RGPCL前后圆锥锥顶K值及角膜厚度进行比较,观察角膜曲率的变化及并发症的发生情况。数据采用配对t检验进行分析。结果所有病例配戴RGPCL初期获得满意的矫正视力,框架眼镜矫正视力与RGPCL比较差异有统计学意义（t=-25.55,P<0.05）。4年后,框架眼镜矫正视力与RGPCL矫正视力差异有统计学意义（t=-30.02,P<0.05）。配戴RGPCL前及4年后圆锥锥顶K值比较差异有统计学意义（t=3.02,P＜0.05）,圆锥锥顶厚度比较差异无统计学意义（t=1.46,P＞0.05）。432眼（87.1％）的配适状态为三点接触,46眼（9.3％）为顶点充盈,18眼（3.6％）为可接受的顶点接触。角膜曲率变化情况为,仅3眼（0.6%）陡峭角膜曲率值增加,64眼（12.9%）扁平角膜曲率值增加。随访期间,所有病例均未弃戴,33眼（6.6％）出现角膜上皮点状着染,未发现角膜缘新生血管,无角膜溃疡等严重并发症。结论圆锥角膜患者配戴RGPCL能获得满意的矫正视力,能延缓圆锥角膜发展,且无严重并发症发生。     

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。     

硬性高透氧性角膜接触镜矫正外伤性角膜散光应用研究

目的 探讨硬性高透氧性角膜接触镜(rigid gas permeable contact lens,RGPCL)矫正外伤性角膜散光患者视力的临床应用价值.方法 对连续收集的18例眼前段外伤患者实施RGPCL验配,随访6个月以上.配戴前记录项目:年龄、性别、眼别、RGPCL验配与角膜拆线的间隔时间、晶状体状态、裸眼视力、框架镜矫正视力、伤口的大小位置、角膜前表面散光值.配戴后观察项目:RGPCL矫正视力、坚持戴镜时间、停戴原因、眼部并发症、长期配戴成功与否.长期配戴成功定义为在随访期间能坚持长期舒适配戴时间≥8 h/d.视力转换成五分制进行统计.采用SPSS 16.0软件系统,运用配对资料t检验、独立样本t检验和协方差分析进行数据统计.结果 患者年龄5～45 (20.94±13.35)岁,人工晶状体眼5只眼,无晶状体眼1只跟,其余12只眼为有晶状体眼.根据伤口位置,1区9只眼,2区9只眼.角膜伤口大小为1.50～8.33 (4.04±2.23) mm,1区和2区之间伤口大小无统计学意义(t =-0.967,P=0.348).RGPCL验配与角膜拆线的间隔时间3～22个(5.67±5.52)月.裸眼视力3.0～4.9(4.2±0.5),框架眼镜矫正视力4.0～4.9(4.6±0.3),RGPCL矫正视力4.4～5.1(4.9±0.1).RGPCL较框架镜矫正视力明显提高(t =4.143,P＜0.000).RGPCL较框架眼镜矫正视力提高1行7只眼,2～4行6只眼,≥5行4只眼.角膜分区伤口之间,RGPCL矫正视力差异无统计学意义(F=0.826,P=0.379),与框架镜矫正视力差异显著有统计学意义(F=5.128,P=0.040),RGPCL较框架镜矫正视力提高幅度差异显著有统计学意义(F=7.286,P=0.017).伤口大小对RGPCL矫正视力、框架镜矫正视力、裸眼视力及视力提高幅度等均无显著影响.随访期间,患者均未出现习惯性镜片脱落,2只眼发生点状角膜上皮炎.长期配戴成功患者4例中,10岁以下2例,10～20岁2例,无大于20岁者,其停戴原因多为初期配戴时有异物感、反复眼红以及无长期伤眼视力矫正需求等.结论 与框架眼镜相比,RGPCL矫正视力是评估伤眼最佳矫正视力更为理想的判定指标;但是,RGPCL并不是所有眼外伤患者长期视力矫正的理想方式.     

硬性透气性角膜接触镜对超高度近视患者视觉相关生活质量的影响

目的观察佩戴硬性透气性角膜接触镜(RGPCL)对超高度近视患者视力及视觉相关生活质量(QOL)的影响。方法回顾性病例系列研究。纳入2019年6月至2022年6月郑州大学第一附属医院验配RGPCL的超高度近视患者43例(86只眼), 验配RGPCL前进行综合验光, 获取其屈光度及框架眼镜最佳矫正视力(BCVA, logMAR), 并采用美国眼科学会视功能问卷(NEI-VEQ-25)中文版量表自我评估视觉相关生活质量分析, 连续佩戴RGPCL 1个月后, 测量患者佩戴RGPCL的视力, 并再次使用NEI-VFQ-25问卷进行自我打分, 分析佩戴RGPCL对视力及NEI-VFQ-25问卷评分的影响。结果验配RGPCL前框架眼镜BCVA右眼为0.2(0, 0.3)、左眼为0.2(0, 0.4), 佩戴RGPCL 1个月时RGPCL戴镜视力右眼为0.1(0, 0.2)、左眼为0(-0.1, 0.3), 双眼RGPCL戴镜视力与框架眼镜BCVA相比有显著提高, 差异有统计学意义(Z=-5.06、-5.21, 均P<0.001);佩戴RGPCL 1个月时NEI-VFQ-25问卷评分与佩戴RGP...     

RGPCL与框架眼镜对高度近视和散光的矫正效果

目的：探讨硬性透气性角膜接触镜（RGPCL）与框架眼镜对高度近视和散光的矫正效果。方法：回顾性自身对照研究。选择2017年1月至2018年12月在惠州爱尔眼科医院视光与小儿眼科门诊验配RGPCL且连续配戴1个月以上并在配戴RGPCL前连续配戴框架眼镜1个月以上的患者41例（75眼）,其中高度近视眼38眼（高度近视组）,高度散光眼37眼（高度散光组）。分别比较2组组内配戴框架眼镜和RGPCL的矫正效果。数据采用配对t检验进行比较。结果：41例（75眼）均成功验配RGPCL。高度近视组配戴RGPCL的最佳矫正视力（BCVA）为5.02±0.16,而配戴框架眼镜BCVA为4.91±0.16,差异有统计学意义（t=11.204,P=0.001）,其中13眼BCVA在配戴RGPCL后提高2行至2行以上,1眼视力下降。高度散光组配戴RGPCL的BCVA为4.95±0.10,而配戴框架眼镜的BCVA为4.83±0.16,差异有统计学意义（t=8.431,P=0.001）,其中12眼BCVA在RGPCL的配戴下提高2行至2行以上。结论：配戴RGPCL在矫正高度近视与散光的视力效果方面优于框架眼镜,具有临床优势。     

RGPCL矫正角膜手术后圆锥角膜和不规则散光的疗效观察

目的 观察RGPCL矫正角膜手术后圆锥角膜和不规则散光的临床疗效和安全性。方法 回顾性病例研究。选择因角膜手术后继发圆锥角膜和不规则散光而验配RGPCL的患者29例（38眼）,其中 LASIK术后继发圆锥角膜12例（14眼）、LASEK术后继发圆锥角膜1例（1眼）、角膜移植术后不规则散光8例（13眼）、放射状角膜切开术后不规则散光2例（4眼）、LASIK术后不规则散光6例（6眼）。在裂隙灯下进行RGPCL试戴荧光素染色评估后确定处方。采用配对t检验对框架眼镜和RGPCL的矫正视力进行比较。患者填写主观自评表评价配戴RGPCL的舒适度和取戴、清洗镜片的难易度。结果 配戴框架眼镜最佳矫正视力≤4.2、4.3~4.4、4.5~4.6、4.7~4.8、4.9~5.0、>5.0分别为5眼（13%）、5眼（13%）、8眼（21%）、10眼（26%）、10眼（26%）、0眼（0%）。戴RGPCL后拥有相应程度最佳矫正视力的眼数分别为0眼（0%）、0眼（0%）、0眼（0%）、3眼（8%）、15眼（39%）、20眼（53%）。配戴RGPCL最佳矫正视力好于框架眼镜（t=-4.416,P＜0.01）。配戴者觉得舒适及取戴、清洁容易的分别为48%、69%、59%。随访期间未发现明显眼部并发症。结论 RGPCL矫正角膜手术后继发圆锥角膜和不规则散光的视觉效果优于框架眼镜,且无明显的并发症发生。     

高透氧硬性接触镜对LASIK术后圆锥角膜的矫治

目的 探讨高透氧硬性接触镜（RGPCL）对LASIK术后圆锥角膜的矫治效果.设计回顾性病例系列.研究对象LASIK术后圆锥角膜患者31例（41眼）.方法 患者戴用RGPCL,随诊1～60个月.比较配戴框架眼镜与RGPCL的矫正视力 随访5年观察配戴RGPCL后角膜曲率半径和角膜散光的改变量.主要指标矫正视力,角膜曲率,角膜散光.结果 LASIK术后轻度、中度和重度圆锥角膜组的平均插片矫正视力和RGPCL矫正视力分别为（0.7±0.2）和（1.0±0.1）（P=0.005） （0.3±0.2）和（1.0±0.1）（P=0.000） 和（0.1±0.1）和（0.8±0.2）（P=0.000）.圆锥角膜患者配戴RGPCL能够达到比插片视力更好的矫正视力.戴RGPCL后,一年内角膜平均曲率半径逐渐变平,以后角膜曲率半径基于这个数值,上下变动在0.05 mm左右.戴RGPCL后角膜平均散光在前半年逐渐减少,三年时有所增加,但仅是0.25 D的改变量,五年时又有所减少,基本稳定在初诊时的散光状态.结论 LASIK术后圆锥角膜的患者配戴RGPCL能获得较好的矫正视力,能相对控制角膜的继续前突,减少角膜散光的发展.     

硬性高透氧角膜接触镜与框架眼镜矫正超高度近视眼比较分析

目的比较超高度近视患者戴用框架镜和硬性高透氧角膜接触镜（RGPCL）后的视力差异及影响因素。方法对62例（113只眼）超高度近视患者验配RGPCL,观察验配RGPCL后的最佳矫正视力（BCVA）及配适情况,定期复诊,观察有无眼部并发症,并与框架镜配戴进行比较。结果113只眼配戴RGPCL后BCVA4．89±0．16,配戴框架眼镜后BCVA4．70±0．27。配戴RGPCL最佳矫正视力均好于或等于配戴框架眼镜的最佳矫正视力,平均视力提高均值为0．19±0．16,二者比较有显著统计学差异（t=38．71,P〈0．01）。统计显示近视度数越高者戴用RGPCL比戴用框架眼镜视力提高越明显。最佳矫正视力的结果与等效球镜屈光度和验配RGPCL前是否进行屈光矫正等因素密切相关。结论配戴RGPCL可减少框架镜带来的像差、物像畸变及视野影响等不足,使患者获得良好的视觉质量,有较好的舒适度,为超高度近视患者视力矫正的理想选择。     

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.     

Management of pellucid marginal corneal degeneration with rigid gas permeable contact lenses.

PURPOSE: To study the clinical performance of rigid gas permeable contact lenses (RGPCL) in patients with pellucid marginal corneal degeneration (PMCD). METHODS: This retrospective study consisted of 15 patients with clinical PMCD, confirmed by videokeratography (TMS-1, Computed Anatomy, Inc., New York, NY). Information collected from the medical records included patient demographic data, uncorrected visual acuity, refraction, best-corrected spectacle visual acuity, and topographic details, including kerotometry. Twenty-seven of 30 eyes were subjected to several contact lens trials using polymethylmethacrylate (PMMA) contact lenses, using a systematic and consistent approach. After successful contact lens trials, data regarding number of trials, trial time, final contact lens choice parameters, and best-corrected contact lens visual acuity were noted for each patient. During follow-up, visual acuity with RGPCLs, lens fit, and average wearing time were noted. RESULTS: Fifteen patients (30 eyes) with typically inferiorly located pellucid marginal corneal degeneration were included in this study. There were 12 men and 3 women, with a mean age of 39.73 years. Twenty-seven eyes of 15 patients were identified as subjects for multiple contact lens trials, and 24 (88.8%) eyes were successfully fitted with RGPCLs. Best-corrected visual acuity of 6/12 or better with spectacles was achieved in 14 (46.66%) eyes. The average astigmatism was -8.56D, and a majority of the patients with PMCD who were in the contact lens trial had an against-the-rule astigmatism (63.3%). The mean trial time for attempted eyes (i.e., patients with PMCD who successfully underwent the contact lens trials) was 77.7 minutes, and the number of trials required to finalize the choice of contact lenses ranged between 2 and 7. The median base curve for RGP lenses was 7.57, and median diameter was 10.00 mm. Best-corrected visual acuity of 6/12 or better with the final contact lens was achieved in 95.4% of the subjects. After an average follow-up of 22.91 months, one patient was lost to follow-up, and 2 eyes required discontinuation of the contact lenses. The average wearing time among the contact lens wearers at their last follow-up visits was 9.58 hours. Final visual acuity of 6/12 or better was observed in 77.3% of eyes at the end of 22.91 months. CONCLUSION: Large-diameter RGPCLs are better tolerated and lead to significant improvement in visual acuity in inferior PMCD.     

Reverse geometry contact lens fitting after corneal refractive surgery

PURPOSE: To describe reverse geometry rigid gas permeable (RGP) contact lens fitting in eyes with irregular surface induced by complications after myopic corneal refractive surgery. METHODS: Reverse geometry RGP contact lenses were fit in nine eyes that underwent myopic corneal refractive surgery and experienced a reduction in best spectacle-corrected visual acuity (BSCVA) Snellen lines postoperatively. RESULTS: Comparing the BSCVA with contact lenses, 5 (55.6%) eyes improved > or = 2 lines of BSCVA, 2 (22.2%) eyes improved 1 line, and 2 (22.2%) eyes maintained the same BSCVA as the one eye with spectacles (P < .004). No eye lost lines of BSCVA. All patients reported excellent tolerance and subjective visual quality with the contact lenses. The mean time of contact lens wear was 10.44 +/- 0.88 hours per day (95% confidence interval, 9.76 to 11.12). CONCLUSIONS: Reverse geometry RGP contact lens fitting is effective in correcting surgically induced irregular surfaces with improved visual acuity and comfortable wear. These lenses may be the best choice in cases in which surgical retreatment is unfeasible or undesirable.     

Synergeyes versus soft toric lenses: vision-related quality of life.

PURPOSE: The purpose of this study is to contrast the clinical and vision-related quality of life outcomes between Synergeyes, a hybrid contact lens, and Bausch & Lomb Soflens 66 Toric contact lenses in a cross-over design. Also, to determine subject preference of one mode of lens wear over the other. METHODS: The Synergeyes lens has a central rigid gas permeable portion made of Paragon HDS100 material (paflufocon D) bonded to the nonionic hydrophilic skirt material of 27% water (PolyHEMA hem-iberfilcon A). The Soflens 66 Toric lens is made of a nonionic hydrophilic 66% water (alphafilcon A) material. Subjects age 18 years and older with spherical refractive error between -0.50 and -8.00 D and astigmatism correction of -0.75 to -3.50 D were randomly assigned to wear one mode of contact lens for 1 month then wear the alternate mode for 1 month. Follow-up visits were done at 1 and 4 weeks. Data gathered at these visits included high-contrast log MAR distance visual acuity, average wearing time, comfortable wearing time, over-refraction, and slit lamp observations for corneal edema, conjunctival hyperemia, and corneal staining. At each visit, subjects were asked to rate overall comfort, dryness, and comfortable wearing time. Subjects were asked to complete the NEI-RQL-42 questionnaire at the end of each lens wearing period. Upon completion of both lens wearing modes, subjects were asked to choose their preferred mode. RESULTS: Fifty subjects completed the study; 22 (44%) preferred the Synergeyes lenses, and 28 (56%) preferred the Soflens 66 Toric soft lenses. Measured visual acuity was significantly better with the Synergeyes lenses. Of the 13 attributes analyzed in the RQL-42, a statistically significant difference between the two modes was found in only one category, "symptoms." In that category, subjects indicated fewer symptoms when wearing soft lenses. The subjects' ratings also showed significantly more comfort while wearing the soft toric lenses. CONCLUSIONS: Bausch & Lomb Soflens 66 Toric lenses were more comfortable and were perceived to produce less symptoms of dryness, itchiness, and lens awareness than Synergeyes lenses. Synergeyes lenses gave better visual acuity than the soft toric lenses.     

硬性透气性角膜接触镜矫正成人超高度近视

目的探讨硬性透气性角膜接触镜（RGPCL）矫正成人超高度近视的临床效果。方法回顾性病例研究。选择在湖南省人民医院眼视光医学中心验配RGPCL的24例（43眼）成人超高度近视患者,根据其屈光度、角膜地形图、角膜曲率和配适情况选择合适的RGPCL镜片。戴镜后7d、1个月、3个月、6个月观察配戴RGPCL时的矫正视力、不良反应和并发症。采用卡方检验和非参数检验对数据进行分析。结果框架眼镜最佳矫正视力平均为4．62-0．15,≥4．9者1眼,占2％：配戴RGPCL后最佳矫正视力平均为4．77-0．16,94．9者16眼,占37％,差异有统计学意义（x^2=16．496,P〈0．05）;与戴镜后7d相比,戴镜后1个月舒适度指标总积分及异物感、视力波动、痒、刺痛、干涩、充血症状的积分均下降,差异均有统计学意义（x^2=63．948、63．823、39．168、6．459、57．733、44．164、39．420,P均〈0．05）。与戴镜后1个月相比,戴镜后3个月总积分、异物感、视力波动、充血症状积分持续下降,差异均有统计学意义（x^2=35．536、22．484、11．537、16．229,P均〈0．05）;痒、刺痛、干涩症状积分与戴镜后1个月差异无统计学意义（x^2=0．000、1．184、1．398,P均〉0．05）。镜片配适中心定位好,活动度良好,未见角结膜严重并发症。结论RGPCL矫正成人超高度近视可明显提高其矫正视力,能有效提高患者的视觉质量和生活质量。     

Rose K硬性透气性角膜接触镜矫正完成期圆锥角膜屈光不正临床效果

目的总结Rose K硬性透气性角膜接触镜（Rose K RGPCL）矫正完成期圆锥角膜患者屈光不正的临床效果。方法回顾性病例研究。2011年2月至2012年5月,55例（59眼）完成期圆锥角膜患者在山东省眼科医院接受了Rose K RGPCL验配矫正,用角膜荧光染色法判断戴Rose K RGPCL 静态配适状态。对戴RGPCL前角膜地形图9 mm直径上0°、90°、180°、270° 4个点和锥顶角膜曲率值之间,裸眼视力（UCVA）、最佳眼镜矫正视力（BSCVA）和戴Rose K RGPCL 矫正视力之间,UCAV、BSCAV和戴Rose K RGPCL 3种状态下对比度视力之间,角膜平、陡、平均曲率半径及镜片基弧之间的差异采用方差分析进行比较。结果59眼角膜地形图周边4个点和锥顶角膜曲率两两比较,锥顶与周边4组差异均有统计学意义（P均<0.01）; 相同对比度下UCVA、BSCVA及戴Rose K RGPCL矫正视力两两比较差异均有统计学意义（P均<0.01）;镜片基弧与角膜平K、平均曲率半径两两比较差异均无统计学意义（P＞0.05）。结论完成期圆锥角膜患者验配Rose K RGPCL镜片能达到理想配适状态并获得较好的矫正视力及低对比度视力;验配过程中平坦曲率半径或平均曲率半径可以做为选择试戴片的基础。     

Current perspectives in the management of keratoconus with contact lenses

Our aim is to review current and significant articles on contact lens wear in keratoconus patients. A comprehensive literature search of PubMed was performed for the following topics on contact lens wear in keratoconus patients: (1) characteristics of contact lens wearers, (2) safety and efficacy, (3) complications, (4) fitting techniques, (5) contact lens wear after procedures/surgeries, (6) patient satisfaction. A total of 104 studies were finally selected and reviewed. Gas permeable (GP) lens wear provided significantly better vision than glasses. Special cone design lenses had better patient comfort levels though there was no difference in best corrected visual acuity among the GP lenses. Soft lenses showed good efficacy for the treatment of mild-to-moderate keratoconus with newer designs improving visual performance such as customised hydrogel and novel pinhole lenses. Scleral and hybrid lenses provide good visual acuity and comfort for keratoconic patients previously intolerant to RGP lenses. RGP lens wear post-cross linking (CXL) is relatively well-tolerated. Contact lenses may still be required post intrastromal corneal ring procedures and post keratoplasty. Scheimpflug imaging and anterior segment optical coherent tomography (ASOCT) are useful in contact lens fitting. Computerized contact lens fitting techniques could reduce the chair time of lens fitting as well as improve comfort and visual performance. Contact lenses play an important role in the visual rehabilitation of keratoconus patients. New contact lens designs and materials have significantly expanded the available fitting options for keratoconus patients. Imaging technology can be utilized to guide contact lens fitting.Subject terms: Rehabilitation, Rehabilitation, Implants     

硬性透气性角膜接触镜矫正近视的安全性和有效性

目的：评价普诺瞳®硬性透气性角膜接触镜（RGPCL）应用于视力矫正的安全性和有效性。方法：前瞻性随机对照研究。选取2016年6月至2017年7月期间在温州医科大学附属眼视光医院、广西壮族自治区人民医院、复旦大学附属眼耳鼻喉科医院就诊的双眼近视患者，随机分配至观察组和对照组，观察组配戴爱博诺德（北京）医疗科技股份有限公司生产的普诺瞳®RGPCL（型号：RAR、RAS），对照组配戴香港易安易光学有限公司生产的RGPCL（型号：XO RGP）。在配戴当天，配戴后1周、1个月、3个月进行访视，对双眼进行评估，包括裸眼远视力（UCDVA）、框架镜最佳矫正远视力（BCDVA）、RGPCL矫正远视力（CDVA）、等效球镜度（SE）、角膜K值、角膜内皮细胞、镜片适配状态、镜片情况及不良反应等。采用独立样本t检验、Wilcoxon秩和检验、CMH检验等进行数据分析。结果：共155例患者完成初次配戴，观察组76例，对照组79例。戴镜当天，观察组和对照组RGPCL CDVA分别为右眼0（-0.10，0）、0（-0.20，0）和左眼0（-0.20，0）、0（-0.20，0），组间差异无统计学意义。配戴后各随访时间点，2组双眼的UCDVA、框架镜BCDVA、RGPCL CDVA、裸眼主观验光SE、戴RGPCL主观验光SE、角膜K值的组间差异均无统计学意义。戴镜3个月，均未出现严重并发症，2组结膜充血发生率、角膜上皮点状着色发生率的差异均无统计学意义。结论：普诺瞳®RGPCL与XO RGP型号的RGPCL用于矫正近视的疗效一致且均具有较高的安全性。