Porcar Esteban, España Enrique, Montalt Juan Carlos, Benlloch-Fornés Josefa Isabel, Peris-Martínez Cristina
Department of Optics (E.P., J.C.M, J.I.B-F.), Optometry and Vision Science, Physics College, University of Valencia, Burjassot, Valencia, Spain; Department of Surgery (E.E.), Ophthalmology Unit, La Fe University and Polytechnic Hospital, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; and FISABIO Oftalmología Médica (FOM) (C.P-M.), Cornea Unit and Anterior Segment Diseases, Catholic University of Valencia, Valencia, Spain.
Eye Contact Lens. 2017 Jan;43(1):46-50. doi: 10.1097/ICL.0000000000000231.
To evaluate the visual quality results of fitting a corneoscleral contact lens with multiaspheric geometry design (MAGD CScL) in subjects with irregular corneas after laser-assisted in situ keratomileusis (LASIK) surgery.
From a database of patients evaluated for scleral contact lenses, we identified those with irregular corneas and visual problems after they underwent LASIK surgery for correcting myopia. They manifested unsatisfactory visual quality with their current contact lenses or glasses. Therefore, a MAGD CScL was fitted and monitored according to standardized fitting methodology. A diagnostic trial set was used in the fitting process. Visual acuity (VA), subjective visual quality (SVQ), and ocular aberrations were evaluated. A new re-evaluation of these parameters was performed after 1 year wearing MAGD CScL.
Eighteen eyes of 18 patients (10 male and 8 female) with irregular cornea after LASIK surgery participated in this study; their ages ranged from 27 to 39 years (mean±SD, 32.6±3.8 years). All patients showed good fitting characteristics: optimal values were seen for lens position and lens movement. Statistically significant differences were found between before and after fitting MAGD CScL in the VA (mean±SD, 0.14±0.03 logMAR and 0.01±0.06 logMAR, respectively; P<0.001); ocular aberrations of second-order, coma, spherical; and the total higher-order aberrations (HOAs) (all P<0.001). The total HOAs decreased by approximately 78% to normal levels after fitting MAGD CScL. In addition, SVQ was also significantly improved after fitting MAGD CScL (16 eyes were favorable or very favorable). After 1 year wearing MAGD CScL, no statistically significant differences were found in the total HOAs and VA in regard to the initial fitting.
Corneoscleral contact lens with multiaspheric geometry design is proposed as an effective procedure, providing a good VA and an optimal visual quality on irregular corneas after LASIK surgery in myopic subjects.
评估在准分子原位角膜磨镶术(LASIK)术后角膜不规则的受试者中,验配多非球面几何设计的角巩膜接触镜(MAGD CScL)的视觉质量结果。
从一个评估巩膜接触镜的患者数据库中,我们识别出那些在接受LASIK手术矫正近视后角膜不规则且存在视觉问题的患者。他们对当前的隐形眼镜或眼镜的视觉质量不满意。因此,根据标准化验配方法验配并监测MAGD CScL。在验配过程中使用了诊断性试戴镜组。评估了视力(VA)、主观视觉质量(SVQ)和眼像差。在佩戴MAGD CScL 1年后,对这些参数进行了重新评估。
18例LASIK术后角膜不规则患者的18只眼(男性10例,女性8例)参与了本研究;他们的年龄在27至39岁之间(平均±标准差,32.6±3.8岁)。所有患者均表现出良好的验配特征:镜片位置和镜片移动均达到最佳值。在验配MAGD CScL前后,VA(平均±标准差,分别为0.14±0.03 logMAR和0.01±0.06 logMAR;P<0.001)、二阶像差、彗差、球差以及总高阶像差(HOAs)(均P<0.001)存在统计学显著差异。验配MAGD CScL后,总HOAs下降了约78%至正常水平。此外,验配MAGD CScL后SVQ也显著改善(16只眼为良好或非常良好)。佩戴MAGD CScL 1年后,总HOAs和VA与初始验配相比无统计学显著差异。
多非球面几何设计的角巩膜接触镜被认为是一种有效的方法,可为近视患者LASIK术后角膜不规则的患者提供良好的视力和最佳的视觉质量。