Chen Yun-Wen, Lee Jiahn-Shing, Hou Chiun-Ho, Lin Ken-Kuo
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Department of Ophthalmology, LinKo Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No.5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan.
Int Ophthalmol. 2018 Oct;38(5):2199-2204. doi: 10.1007/s10792-017-0702-4. Epub 2017 Aug 30.
To report the refractive correction in a case of hyperopia and astigmatism following radial keratotomy.
A case report.
A 47-year-old woman, who had undergone refractive surgery for radial keratotomy in both eyes 22 years before the present study, presented to our clinic with blurred vision. Her best corrected visual acuity, with spectacle correction of +3.50 DS/-1.50 DCX130° in the right eye and +3.75 DS/-1.50 DCX80° in the left eye, was 0.2 logMAR and 0.3 logMAR, respectively. Her keratometric readings were 35.75 D/36.75 D at 74° and 35.25 D/36.25 D at 61°, respectively. Prompted by intolerance to glasses, the patient requested for contact lenses. First, we applied a rigid, gas-permeable contact lens. However, we noted poor fitting due to central corneal flattening. Subsequently, we applied a conventional plus spherical soft contact lens (PSSCL), which is thick in the center and can therefore correct hyperopia and low-grade astigmatism simultaneously. The conventional PSSCL showed slightly inferior decentration, with good movement, and the patient was satisfied with it. After ascertaining the patient's living habits, we decided that a daily disposable soft contact lens would most meet her needs. The final prescription was a daily disposable PSSCL; the patient was satisfied with her corrected visual acuity of 0.0 logMAR in the right eye and 0.0 logMAR in left eye. Her daily disposable PSSCL-corrected visual acuity was stable during the 10-month follow-up.
For patients displaying hyperopia with astigmatism following radial keratotomy, the PSSCL may confer better corrected visual acuity and acceptability.
报告放射状角膜切开术后远视和散光病例的屈光矫正情况。
病例报告。
一名47岁女性，在本研究前22年双眼接受了放射状角膜切开术屈光手术，因视力模糊前来我院就诊。她右眼最佳矫正视力为0.2 logMAR，眼镜矫正度数为+3.50 DS/-1.50 DC×130°；左眼最佳矫正视力为0.3 logMAR，眼镜矫正度数为+3.75 DS/-1.50 DC×80°。她的角膜曲率读数分别为74°时35.75 D/36.75 D和61°时35.25 D/36.25 D。由于不耐受眼镜，患者要求佩戴隐形眼镜。首先，我们给她佩戴了硬性透气隐形眼镜。然而，由于中央角膜扁平，我们发现佩戴效果不佳。随后，我们给她佩戴了传统的加球软隐形眼镜（PSSCL），这种隐形眼镜中央较厚，因此可以同时矫正远视和低度散光。传统的PSSCL偏心度略差，但活动良好，患者对此感到满意。在了解患者的生活习惯后，我们认为日抛型软隐形眼镜最能满足她的需求。最终处方为日抛型PSSCL；患者对右眼和左眼矫正视力均为0.0 logMAR感到满意。在10个月的随访期间，她日抛型PSSCL矫正的视力保持稳定。
对于放射状角膜切开术后出现远视合并散光的患者，PSSCL可能提供更好的矫正视力和可接受性。
