透气性硬性角膜接触镜矫正亚临床型圆锥角膜的临床观察

目的 观察透气性硬性角膜接触镜(RGPCL)矫正亚临床型圆锥角膜的效果以及长期配戴后角膜地形图的改变.方法 对22例一眼经OrbscanⅡ眼前节系统检查已确诊为圆锥角膜;另一眼角膜地形图显示角膜厚度≤500μm或后表面Diff值≥0.05mm的亚临床型圆锥角膜,根据屈光度、角膜曲率和配适情况,选择适合的镜片.于戴镜后每年行OrbscanⅡ检查,随访两年.观察角膜前表面曲率、角膜前表面及后表面Diff值、I-S值、角膜后表面屈光度、角膜厚度、前房深度的变化.结果 总体平均近视度和散光度分别为(-5.13±2.61)D和(-1.15±0.81)D.框架眼镜矫正视力≥1.0者为16例,占总数的72.7%;戴用RGPCL后矫正视力≥1.0者为100%.配戴RGPCL的矫正效果明显优于框架,视力差异具有统计学意义(P＜0.05).角膜地形图各项值统计结果显示,角膜前表面曲率半径平均值大于配戴前,I-S值降低,差异具有统计学意义(P＜0.05).角膜前表面及后表面Diff值、角膜后表面屈光度、角膜厚度、前房深度前后变化无统计学意义(P＞0.05).结论 RGPCL的合适配戴能在一定程度上控制亚临床型圆锥角膜的进展.

Clinical evaluation of rigid gas-permeable contact lens for subclinical keratoconus

Objective To evaluation the clinical effectiveness of rigid gas permeable contact lenses (RGPCL) for subclinical keratoconus eyes. Methods Twenty-two subclinical stage ofkeratoconus eyes from 22 patients were treated by wearing of RGPCL and followed up for 1-24 months. Orbscan corneal topography system was used before and after the wearing of RGPCL. Results RGPCL can provide a significant improvement in visual acuity compared to spectacle correction for patients (P ＜0.05). Anterior corneal surface became flatter and I-S value became smaller after the fitting ofRGPCL (P ＜0.05). But anterior corneal surface curvature, posterior and anterior corneal surface height, corneal thickness, anterior chamber depth had no significant changes (P ＞0.05). Conclusions It is easy to reach the ideal fit and to improve the visual acuity. The RGPCL has effective orthokeratology for subclinical keratoconus.