Szczotka L B, Barr J T, Zadnik K
University Hospitals of Cleveland and Case Western Reserve University, Department of Ophthalmology, Ohio, USA.
Optometry. 2001 Sep;72(9):574-84.
This summary of the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study includes the study design and results to date.
The CLEK Study is a longitudinal, observational study of 1,209 patients with keratoconus. The study's main outcome measures are corneal scarring, visual acuity, corneal curvature, and quality of life.
These patients' mean age at baseline was 39.3 +/- 10.9 years, and they had moderate to severe keratoconus. Ninety-five percent of the patients had steep keratometric readings of at least 45 D, and 78% had best-corrected visual acuity of 20/40 or better in both eyes. Sixty-five percent of the patients wore rigid gas-permeable contact lenses in both eyes, and most of those (73%) reported that their lenses were comfortable. Most rigid gas-permeable contact lens wearers were fitted with apical touch (88%). Fifty-three percent had corneal scarring in one or both eyes, and corneal scarring was associated with corneal staining, contact lens wear, age, the presence of a Fleischer's ring, and a steeper cornea. Corneal scarring was associated with decreased high- and low-contrast visual acuity.
These results characterize keratoconus patients as rigid gas-permeable contact lens wearers with moderately steep corneas. Corneal scarring is associated with decreased vision in keratoconus.
圆锥角膜协作纵向评估(CLEK)研究的本总结包括研究设计及截至目前的结果。
CLEK研究是一项对1209例圆锥角膜患者的纵向观察性研究。该研究的主要结局指标为角膜瘢痕形成、视力、角膜曲率和生活质量。
这些患者基线时的平均年龄为39.3±10.9岁,患有中度至重度圆锥角膜。95%的患者角膜曲率计读数至少为45 D,78%的患者双眼最佳矫正视力为20/40或更好。65%的患者双眼佩戴硬性透气性角膜接触镜,其中大多数(73%)报告其镜片佩戴舒适。大多数硬性透气性角膜接触镜佩戴者采用顶点接触法(88%)。53%的患者单眼或双眼存在角膜瘢痕形成,角膜瘢痕形成与角膜染色、佩戴角膜接触镜、年龄、Fleischer环的存在以及更陡峭的角膜相关。角膜瘢痕形成与高对比度和低对比度视力下降相关。
这些结果表明圆锥角膜患者多为佩戴硬性透气性角膜接触镜、角膜中度陡峭的人群。角膜瘢痕形成与圆锥角膜患者视力下降相关。