Rathi Varsha M, Mandathara Preeji S, Dumpati Srikanth, Sangwan Virender S
Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India.
Bausch & Lomb Contact Lens Centre, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, TS, India.
Cont Lens Anterior Eye. 2017 Jun;40(3):157-161. doi: 10.1016/j.clae.2017.03.008. Epub 2017 Mar 31.
To assess the change in vault during scleral lens fitting with anterior segment optical coherence tomography (AS-OCT).
This study comprised of patients who had AS-OCT performed after 1h and 4h of scleral lens wear (PROSE, prosthetic replacement of the ocular surface ecosystem, Boston Foundation for Sight, Needham Heights, MA, USA). Vault was measured on AS-OCT as the distance between the front surface of the cornea in the center and the back surface of the scleral lens.
Fifty eyes of 41 patients were analyzed. The main indications for scleral lens trial were ectasia (keratoconus, post surgery) (n=20 eyes) and ocular surface disease (OSD - Stevens - Johnson syndrome, dry eyes and limbal stem cell deficiency) (n=30 eyes). Mean age of the patients was 31.4 years. Twenty were males. The diameter of the scleral lens ranged from 16mm to 18.5mm. Vault measurements reduced in 45/50 eyes (90%), remained same (n=2) or increased (n=3). Overall mean vault decreased from 680±421μm at 1h to 589±355μm (p=<0.001) at 4h of lens wear. Mean vault in ectasia was 759±574μm and 634±455μm (p=0.02) at 1h and 4h of lens wear respectively. In OSD group, mean vault was 626±276μm and 558±273μm (p<0.01) at 1h and 4h of lens wear respectively. Average reduction in the vault was 125μm in ectasia and 68μm in OSD group.
Vault reduced significantly after 4h of lens wear during scleral lens trial indicating that the final assessment of the scleral lens may be done after 4h of lens wear.
使用眼前节光学相干断层扫描（AS-OCT）评估巩膜镜验配过程中房弯的变化。
本研究纳入了在佩戴巩膜镜1小时和4小时后接受AS-OCT检查的患者（PROSE，眼表生态系统假体置换，美国马萨诸塞州尼德姆高地波士顿视力基金会）。在AS-OCT上测量房弯，即角膜中央前表面与巩膜镜后表面之间的距离。
分析了41例患者的50只眼。巩膜镜试戴的主要适应证为扩张性病变（圆锥角膜、手术后）（20只眼）和眼表疾病（OSD - 史蒂文斯 - 约翰逊综合征、干眼和角膜缘干细胞缺乏）（30只眼）。患者的平均年龄为31.4岁。男性20例。巩膜镜直径范围为16mm至18.5mm。50只眼中有45只（90%）房弯测量值减小，2只保持不变，3只增加。总体平均房弯在佩戴镜片1小时时为680±421μm，在佩戴镜片4小时时降至589±355μm（p<0.001）。扩张性病变组在佩戴镜片1小时和4小时时的平均房弯分别为759±574μm和634±455μm（p=0.02）。在眼表疾病组，佩戴镜片1小时和4小时时的平均房弯分别为626±276μm和558±273μm（p<0.01）。扩张性病变组房弯平均降低125μm，眼表疾病组为68μm。
巩膜镜试戴过程中，佩戴镜片4小时后房弯显著降低，表明巩膜镜的最终评估可在佩戴镜片4小时后进行。
