Dominguez Charles E, Shah Arti, Weissman Barry A
Jules Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90024, USA.
Eye Contact Lens. 2005 Sep;31(5):241-3. doi: 10.1097/01.icl.0000156221.47633.1f.
To evaluate the authors' experience fitting patients with pellucid marginal corneal degeneration (PMCD) with bitoric gas-permeable contact lenses.
The records of 11 patients with a confirmed diagnosis of PMCD were retrospectively reviewed. The numbers of diagnostic contact lenses at the first visit, office visits, and lenses ordered to complete the fitting; uncorrected, spectacle-corrected, and contact lens-corrected Snellen visual acuities; contact lens success or failure; and complications encountered were all assessed. These data were compared to historic data for patients with other corneal irregularities (keratoconus, penetrating keratoplasty, and refractive surgery).
The mean number of diagnostic contact lenses used at the first visit was 1.09 +/- 0.302, and the number of lenses ordered to complete the fitting was 1.82 +/- 1.33. The number of visits during 4 months was 6.18 +/- 2.14. Uncorrected visual acuity (logMAR) was 0.957 +/- 0.398 (20/181 in Snellen); the best-corrected spectacle visual acuity (logMAR) was 0.231 +/- 0.309 (20/34 in Snellen); and the best contact lens-corrected visual acuity (logMAR) was 0.0424 +/- 0.06275 (20/22 in Snellen). Corrected vision in eyes with PMCD improved approximately two lines with bitoric gas-permeable contact lenses compared to that achieved with spectacles. Ten (91) of the patients met the criteria of contact lens success during the 4-month follow-up period.
Bitoric gas-permeable contact lenses achieved a comfortable and visually successful fit in most eyes with PMCD. Patients with PMCD used the fewest contact lenses and had the fewest lens exchanges, but required more office visits than other groups of patients with various corneal irregularities.
评估作者为透明边缘角膜变性(PMCD)患者验配双环曲面透气硬性接触镜的经验。
回顾性分析11例确诊为PMCD患者的病历。评估首次就诊时诊断性接触镜的数量、复诊次数以及为完成验配所订购的镜片数量;未矫正、框架眼镜矫正及接触镜矫正的斯内伦视力;接触镜验配的成功或失败情况;以及所遇到的并发症。将这些数据与其他角膜不规则病变(圆锥角膜、穿透性角膜移植术和屈光手术)患者的历史数据进行比较。
首次就诊时使用的诊断性接触镜平均数量为1.09±0.302,为完成验配所订购的镜片数量为1.82±1.33。4个月内的复诊次数为6.18±2.14。未矫正视力(logMAR)为0.957±0.398(斯内伦视力20/181);最佳矫正框架眼镜视力(logMAR)为0.231±0.309(斯内伦视力20/34);最佳接触镜矫正视力(logMAR)为0.0424±0.06275(斯内伦视力20/22)。与框架眼镜相比,PMCD患者使用双环曲面透气硬性接触镜矫正视力提高了约两行。10例(91%)患者在4个月的随访期内达到了接触镜验配成功的标准。
双环曲面透气硬性接触镜在大多数PMCD眼中实现了舒适且视觉效果良好的验配。PMCD患者使用的接触镜数量最少,镜片更换次数也最少,但与其他各类角膜不规则病变患者相比,所需的复诊次数更多。