准分子激光原位角膜磨镶术后的隐形眼镜佩戴：硬性透气性隐形眼镜与软性隐形眼镜的比较

Lim L, Siow K L, Chong J S, Tan D T

Singapore National Eye Center, Singapore.

CLAO J. 1999 Oct;25(4):222-7.

PURPOSE

To determine if rigid gas permeable (RGP) or soft contact lenses can be successfully worn after photorefractive keratectomy (PRK) to correct residual refractive errors.

METHODS

Patients with residual stable ametropia after PRK were fit with RGP or soft lenses. Manifest refraction, corneal topography, and keratometry were performed, and post-PRK corneal haze was graded during the study visits. Contact lens fit characteristics and comfort were assessed. Lens centration, visual quality, and ocular surface status were graded, and visual acuity with contact lenses was charted.

RESULTS

Eighteen patients were recruited for RGP lens fitting. The mean refractive error post-PRK was +0.80 D +/- 2.03 (range: -3.50 to+3.00 D). The mean contact lens power was -3.90 D +/- 2.03 (range: 0 to -7.00 D), and the mean contact lens base curve was 7.88 mm +/-0.16. A significant positive tear film at the site of the central ablation was noted, contributing to excessive minus lens power in all cases. Despite mild to moderate lens instability and de-centration, 14 patients reported excellent visual quality with the lenses, and pre-PRK best-corrected acuity was achieved in all patients. Twenty-five percent (4 of 16) of the patients were able to wear the lenses all day. Eleven patients were recruited for soft contact lens fitting-five from the RGP trial. The mean refractive error post-PRK was -0.64 D +/- 2.01 (range: -3.50 to +1.75D). The mean contact lens power was -0.60 D +/- 2.07 (range: -3.75 to +2.5 D), and the mean contact lens base curve was 8.33 mm +/- 0.42. Eight patients were corrected with lenses to their pre-PRK best-corrected acuity, and nine patients reported excellent visual quality with the lenses. All the patients had excellent lens centration. Thirty-six percent (four of 11) of patients were wearing the lenses all day.

CONCLUSIONS

Fitting RGP lenses after PRK results in good visual acuity but may be associated with mild to moderate lens instability and decentration. Soft contact lens fitting also results in good visual acuity. Soft lenses were better tolerated by the subjects in our study because of improved lens centration and stability.

目的

确定在准分子激光角膜切削术（PRK）后能否成功佩戴硬性透气性（RGP）或软性隐形眼镜来矫正残余屈光不正。

方法

对PRK术后残余稳定屈光不正的患者验配RGP或软性隐形眼镜。进行显验光、角膜地形图检查和角膜曲率测量，并在研究随访期间对PRK术后角膜 haze 进行分级。评估隐形眼镜的适配特征和舒适度。对镜片的中心定位、视觉质量和眼表状态进行分级，并记录佩戴隐形眼镜后的视力。

结果

18例患者纳入RGP镜片验配。PRK术后平均屈光不正为+0.80 D±2.03（范围：-3.50至+3.00 D）。平均隐形眼镜度数为-3.90 D±2.03（范围：0至-7.00 D），平均隐形眼镜基弧为7.88 mm±0.16。在中央切削部位观察到明显的正性泪膜，导致所有病例中负镜片度数过高。尽管镜片存在轻度至中度不稳定和偏心，但14例患者报告镜片视觉质量良好，所有患者均达到PRK术前最佳矫正视力。25%（16例中的4例）患者能够全天佩戴镜片。11例患者纳入软性隐形眼镜验配，其中5例来自RGP试验。PRK术后平均屈光不正为-0.64 D±2.01（范围：-3.50至+1.75 D）。平均隐形眼镜度数为-0.60 D±2.07（范围：-3.75至+2.5 D），平均隐形眼镜基弧为8.33 mm±0.42。8例患者佩戴镜片后矫正至PRK术前最佳矫正视力，9例患者报告镜片视觉质量良好。所有患者镜片中心定位良好。36%（共11例中的4例）患者全天佩戴镜片。