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圆锥角膜患者管理中的当前验光实践与态度

Current optometric practices and attitudes in keratoconus patient management.

作者信息

Ortiz-Toquero Sara, Martin Raul

机构信息

Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Paseo de Belén, 7 - Campus Miguel Delibes, 47011 Valladolid, Spain; Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, 47011 VALLADOLID, Spain; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain.

Universidad de Valladolid, Departamento de Física Teórica, Atómica y Óptica, Paseo de Belén, 7 - Campus Miguel Delibes, 47011 Valladolid, Spain; Universidad de Valladolid, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Paseo de Belén, 17 - Campus Miguel Delibes, 47011 VALLADOLID, Spain; Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, Valladolid, Spain; Faculty of Health and Human Sciences, Plymouth University, Derriford Road, PL6 8BH Plymouth, United Kingdom.

出版信息

Cont Lens Anterior Eye. 2017 Aug;40(4):253-259. doi: 10.1016/j.clae.2017.03.005. Epub 2017 Mar 18.

Abstract

PURPOSE

To compare the current optometric practices and attitudes in the management of keratoconus patients in the UK and Spain.

METHODS

An online survey (adapted to optometric practices) was distributed via a newsletter emailed by various professional organizations in the UK and Spain.

RESULTS

Four hundred and sixty-four practitioners (126 in the UK; 338 in Spain) who prescribed gas permeable GP contact lenses (CLs) more than once per month (54.8% of UK practitioners and 28.1% of practitioners in Spain; p<0.01) responded to the questionnaire. A combination of multiple factors is considered necessary in the keratoconus detection (79.4% in the UK, 75% in Spain; p=0.68), and the use of classification criteria is considered relevant (67.5% in the UK, 70.7% in Spain; p=0.49). There is a high consensus on the consideration that GP CL fitting is more difficult in keratoconus (79.4% in the UK, 80.5% in Spain; p=0.79) requiring more diagnostic lenses (3.2±1.4 and 3.4±1.2 in the UK and Spain, respectively; p=0.72) than are necessary for healthy eyes. Using corneal topography is uncommon from both countries (38.1% in the UK, 59.8% in Spain; p<0.01), with a similar ophthalmologist referral pattern (at initial diagnosis, 50% in both the UK and Spain; p=1.00). Few cases of co-management with ophthalmologists were noted (no co-management reported by 60.3% in the UK and 72.8% in Spain, p=0.01).

CONCLUSION

This study provides initial observations and evidence regarding keratoconus management by optometrists in the UK and Spain and shows similarity in the professional practices and attitudes of practitioners in these two countries.

摘要

目的

比较英国和西班牙在圆锥角膜患者管理方面当前的验光实践和态度。

方法

通过英国和西班牙各专业组织发送的时事通讯分发了一份(适用于验光实践的)在线调查问卷。

结果

464名从业者(英国126名;西班牙338名)回复了问卷,这些从业者每月开具透气性硬性角膜接触镜(CLs)超过一次(英国从业者的54.8%和西班牙从业者的28.1%;p<0.01)。圆锥角膜检测时多种因素的综合考虑被认为是必要的(英国为79.4%,西班牙为75%;p=0.68),并且分类标准的使用被认为是相关的(英国为67.5%,西班牙为70.7%;p=0.49)。对于圆锥角膜中透气性硬性角膜接触镜验配更困难这一点存在高度共识(英国为79.4%,西班牙为80.5%;p=0.79),与健康眼睛相比需要更多的诊断镜片(英国和西班牙分别为3.2±1.4和3.4±1.2;p=0.72)。两国使用角膜地形图的情况都不常见(英国为38.1%,西班牙为59.8%;p<0.01),眼科医生的转诊模式相似(初诊时,英国和西班牙均为50%;p=1.00)。与眼科医生共同管理的病例很少(英国60.3%和西班牙72.8%未报告共同管理情况,p=0.01)。

结论

本研究提供了关于英国和西班牙验光师对圆锥角膜管理的初步观察和证据,并显示了这两个国家从业者在专业实践和态度上的相似性。

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