高透氧新型材料软硬组合型透镜矫正圆锥角膜的优势

目的 评价硅水凝胶软镜(Si-SCL)与高透氧透气性硬性接触镜(RGPCL)组合的透镜(Piggyback lens)的透氧性能.观察其用于圆锥角膜矫正时改善视力、眼表形态和舒适度的效果,角膜的塑形效果及其安全性能.方法 利用欧姆定律计算新材料组合Piggyback lens的透氧率(Dk/t).比较裸眼和Si-SCL戴镜后眼表面曲率和散光的改变.比较单纯RGPCL与Piggyback lens的矫正视力.调查舒适度的改善情况和眼表并发症.利用角膜地形图观察Piggyback lens戴镜后的角膜塑形效果.不同矫正视力、戴镜前后角膜曲率和角膜散光均采用配对t检验进行统计学分析.结果 所用Si-SCL为博士伦纯视(PV)镜片,含水36%,Dk/t为110,RGPCL材料为日本Menicon Z,Dk/t为95.9和美国Boston XO,Dk/t为58.8,组合镜片的Dk/t计算为44.4×10-9和34.4×10-9.22名中重度圆锥角膜患者(28只眼)可成功配戴.Si-SCL配戴后角膜K值和角膜散光明显降低.矫正视力单纯RGPCL平均4.82±0.11,Piggyback lens平均4.93±0.08,有明显提高(t=-10.395,P＜0.01).90%患者感觉舒适度有一定提高.仅个别病例有轻度结膜充血和角膜点染.戴镜6个月以上,角膜地形图显示角膜形态向平坦化、球面化、规则化转变.结论 无论原发性与继发性圆锥角膜,某些中重度疑难病例均可利用高透氧材料组合的Piggyback lens有效解决,既可不同程度提高矫正视力,提高舒适度和安全性,延长戴镜时间,又可进一步提高角膜塑形效应.

Abstract：

Objective To evaluate the oxygen transmissibility of new material Piggyback lens combined with silicone hydrogel lens and higher Dk RGPCL. To investigate the improving of visual acuity,ocular shape and comfortable, also orthokeratology results and safety of this new system for keratoconus correction. Methods Calculating the oxygen transmission (Dk/t) of the new Piggyback system involves Ohm's Law. Compare the changes of ocular surface curves and astigmatism with or without Si-SCL fitting,RGPCL vision and Piggyback lens vision. Investigate the comfortable improving and ocular complications,and changes of corneal shape after fitted with Piggyback lens by using corneal topography. Results Selected silicone hydrogel lens was pure vison (B&L PV, 36% water, Dk/t 110) lens, RGPCL material was Menicon Z, Dk/t 95.9 and Boston XO, Dk/t 58. 8. It was calculated to 44. 4 Dk/t and 34. 4 Dk/t with these two combinations. Twenty two moderate and severe keratokonus patients (28 eyes) fitted with the Piggyback lens successfully. Corneal K reading and astigmatism decreased significantly after wore the Si-SCL.Compared with RGPCL vison(4. 82 ±0. 11 ) ,Piggyback lens vision (4. 93 ±0. 08) was significant increased ( t = - 10. 395 ,P ＜0. 01 )90% cases improved comfort vs prior RGPCL wear alone. Only few cases appeared slight conjunctival hyperemia and corneal staining. Corneal topography showed corneal flauer, spherical and regular reshaping results after 6 months wore the Piggyback lens. Conclusions By fitting Piggyback systems using new Si-SCL and higher Dk RGPCL materials may help problematic keratoconic patients improve visual acuity, comfort and safety, increase wearing time and orthokeratology results further.

Advantage of higher oxygen transmissibility material Piggyback lens for keratoconus correction

Objective To evaluate the oxygen transmissibility of new material Piggyback lens combined with silicone hydrogel lens and higher Dk RGPCL. To investigate the improving of visual acuity,ocular shape and comfortable, also orthokeratology results and safety of this new system for keratoconus correction. Methods Calculating the oxygen transmission (Dk/t) of the new Piggyback system involves Ohm's Law. Compare the changes of ocular surface curves and astigmatism with or without Si-SCL fitting,RGPCL vision and Piggyback lens vision. Investigate the comfortable improving and ocular complications,and changes of corneal shape after fitted with Piggyback lens by using corneal topography. Results Selected silicone hydrogel lens was pure vison (B&L PV, 36% water, Dk/t 110) lens, RGPCL material was Menicon Z, Dk/t 95.9 and Boston XO, Dk/t 58. 8. It was calculated to 44. 4 Dk/t and 34. 4 Dk/t with these two combinations. Twenty two moderate and severe keratokonus patients (28 eyes) fitted with the Piggyback lens successfully. Corneal K reading and astigmatism decreased significantly after wore the Si-SCL.Compared with RGPCL vison(4. 82 ±0. 11 ) ,Piggyback lens vision (4. 93 ±0. 08) was significant increased ( t = - 10. 395 ,P ＜0. 01 )90% cases improved comfort vs prior RGPCL wear alone. Only few cases appeared slight conjunctival hyperemia and corneal staining. Corneal topography showed corneal flauer, spherical and regular reshaping results after 6 months wore the Piggyback lens. Conclusions By fitting Piggyback systems using new Si-SCL and higher Dk RGPCL materials may help problematic keratoconic patients improve visual acuity, comfort and safety, increase wearing time and orthokeratology results further.