Schornack Muriel M, Baratz Keith H, Patel Sanjay V, Maguire Leo J
Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA.
Eye Contact Lens. 2008 Nov;34(6):302-5. doi: 10.1097/ICL.0b013e318188e205.
To describe the use of the Jupiter scleral contact lens (Medlens Innovations, Front Royal, VA or Essilor Contact Lens, Inc., Dallas, TX) in the management of ocular manifestations of chronic graft versus host disease (cGVHD).
This study is a retrospective case series. Five consecutive patients with severe keratoconjunctivitis sicca (KCS) associated with cGVHD that could not be adequately managed with conventional therapy were evaluated for scleral contact lens wear between January and December 2007. All patients were evaluated with lenses from the standard 18.2 mm Jupiter B diagnostic fitting set. If lenses of standard design failed to provide adequate fit, custom lenses were designed. Three outcome measures were evaluated: the patient's ability to tolerate and successfully handle the lenses, improvement in symptoms of KCS, and improvement in visual acuity.
All 5 patients (10 eyes) were successfully fit with Jupiter scleral lenses. Six eyes of 3 patients were successfully fit with lenses of standard design. Standard parameters were altered to achieve adequate fit in 4 eyes of 2 patients. All patients reported subjective improvements in comfort with Jupiter scleral lenses, and best-corrected vision improved in 7 of the 10 eyes fit within the first several months of contact lens wear. The remaining 3 eyes maintained the visual acuity measured before scleral lens wear (20/20 in 2 eyes, 20/40 in 1 eye). Duration of follow-up ranged from 4 to 14 months.
Jupiter scleral lenses can relieve symptoms of KCS and may improve vision in patients with cGVHD.
描述使用朱庇特巩膜接触镜（Medlens Innovations公司，弗兰特罗亚尔，弗吉尼亚州或依视路隐形眼镜公司，达拉斯，得克萨斯州）治疗慢性移植物抗宿主病（cGVHD）眼部表现的情况。
本研究为回顾性病例系列研究。2007年1月至12月期间，对5例连续的、患有与cGVHD相关的严重干燥性角结膜炎（KCS）且常规治疗无法充分控制病情的患者进行了巩膜接触镜佩戴评估。所有患者均使用标准的18.2毫米朱庇特B诊断试戴套装中的镜片进行评估。如果标准设计的镜片未能提供合适的贴合度，则设计定制镜片。评估了三项结果指标：患者耐受并成功处理镜片的能力、KCS症状的改善情况以及视力的改善情况。
所有5例患者（10只眼）均成功佩戴了朱庇特巩膜镜片。3例患者的6只眼成功佩戴了标准设计的镜片。对2例患者的4只眼改变了标准参数以实现合适的贴合度。所有患者均报告佩戴朱庇特巩膜镜片后舒适度有主观改善，在佩戴隐形眼镜的前几个月内，10只眼中有7只眼的最佳矫正视力有所提高。其余3只眼维持了佩戴巩膜镜片前测得的视力（2只眼为20/20，1只眼为20/40）。随访时间为4至14个月。
朱庇特巩膜镜片可缓解KCS症状，并可能改善cGVHD患者的视力。
