圆锥角膜配戴硬性透气性角膜接触镜后角膜表面形态的改变

目的 评价圆锥角膜患者配戴硬性透气性角膜接触镜(RGP)后角膜前表面非球面形态(Q值)的改变以及SimK值的改变。方法 收集山西省眼科医院就诊的圆锥角膜患者25人43只眼，选配合适的RGP，分别于配戴前及配戴后1个月、3个月、6个月、12个月测定其矫正视力，并进行OPD-scan角膜地形图检查，采集角膜中央散光值、SimK值、Q值等参数，分析Q值及SimK值随配戴时间的变化，SimK值改变与角膜Q值改变有无相关性。结果 患者配戴RGP前，角膜散光值、Simk值、Q值分别为-6.03±2.66、50.12±5.65、-2.29±1.17。配戴RGP 3个月后角膜散光值、Simk值、Q值分别为-4.07±1.97、49.47±5.55、-1.62±0.95。角膜散光值、Simk值、Q值在配戴RGP前后差异有统计学意义。SimK值改变与角膜Q值改变有着显著的相关性，相关系数为0.698。配戴3个月、6个月及12个月后，角膜散光值，Simk值，Q值差异无统计学意义。结论 RGP为圆锥角膜患者提供了良好的视力矫正，并且可以在一定程度上改变角膜前表面的形态，从而控制圆锥角膜病情的发展。这种改变在配戴后3个月较为明显。随着配戴时间的延长，角膜散光值，Simk值,Q值趋于稳定。

Change of corneal surface shapes in keratoconus corrected with RGPCL

Objective To investigate the changes of Q-value and simK-value in keratoconus corrected with RGPCL. Methods Twenty-five patients confirmed by corneal topography as keratoconus were correlated with RGPCL and followed by 1 month, 3, 6 and 12 months. Their corrected visual acuity (VA) and corneal topography were detected by OPD-scan. Cornea astigmatism, simK-value and Q-value were measured. Results Cornea astigmatism, simK-value and Q-value was -6.03 ± 2.66, 50.12± 5.65, and -2.29± 1.17 before wearing RGP respectively. With RGPCL for 3 months, cornea astigmatism, simK-value and Q-value was -4.07D± 1.97, 49.47± 5.55, and -1.62± 0.95 respectively.Corrected visual acuity (VA) was improved after wearing RGPCL. Corneal surface shapes were regular than before. There was prominent correlate between change of corneal simK-value and change of Q-value after wearing RGP for 3 months. After wearing RGP for 3, 6 and 12 months, there were no significant changes in cornea astigmatism, simK-value and Q-value. Conclusions Keratoconus patients with RGPCL can reach satisfying corrected visual acuity and visual quantity. RGPCL can modify irregular astigmatism and change corneal surface shapes, so to control the improvement of keratoconus.Changes of corneal surface shapes are significant after 3 months' wearing, with time going, cornea astigmatism, simK-value and Q-value are stable.