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巩膜镜佩戴后圆锥角膜患者有无环形节段时的角膜前表面曲率和像差变化

Anterior Corneal Curvature and Aberration Changes After Scleral Lens Wear in Keratoconus Patients With and Without Ring Segments.

作者信息

Serramito-Blanco Maria, Carpena-Torres Carlos, Carballo Jesús, Piñero David, Lipson Michael, Carracedo Gonzalo

机构信息

Department of Optics II (Optometry and Vision) (M.S.-B., C.C.-T., J.C., G.C.), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain; Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy (D.P.), University of Alicante, Spain; Department of Ophthalmology (OFTALMAR) (D.P.), Vithas Medimar International Hospital, Alicante, Spain; Department of Ophthalmology and Visual Science (M.L.), University of Michigan, Northville, MI; and Ocupharm Group Research (G.C.), Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain.

出版信息

Eye Contact Lens. 2019 Mar;45(2):141-148. doi: 10.1097/ICL.0000000000000534.

Abstract

OBJECTIVE

To evaluate changes in the anterior corneal curvature and aberrometry after scleral contact lens wear in keratoconus (KC) subjects with and without intracorneal ring segments (ICRS).

METHODS

Twenty-six subjects diagnosed with keratoconus were selected to participate in the study. Subjects were divided into 2 groups, those with ICRS (KC-ICRS group) and those without ICRS (KC group). Subjects were instructed to wear 16.5-mm scleral lenses for 8 hours. Topographic and aberrometric parameters were evaluated before lens wear and immediately after lens removal. Anterior corneal curvature was evaluated at corneal diameters of 2, 4, 6, and 8 mm, and corneal aberrations were measured at 4-, 6-, and 8-mm pupil diameters.

RESULTS

The mean age of subjects was 36.95±8.95 years. In KC group, there was a statistically significant flattening of the central corneal curvature, from 6.98 to 7.09 mm (P<0.05). No changes were found in the central corneal curvature in the KC-ICRS group. The KC group showed anterior corneal curvature flattening, mainly in the nasal quadrant. The KC-ICRS group showed flattening primarily in the inferior hemisphere. In the KC group, spherical aberration for 6-mm pupil increased significantly. In the KC-ICRS group, changes in aberrations were significant for high-order root mean square at 4- and 6-mm pupil diameters (P<0.05), for oblique astigmatism for 4 mm and 6 mm, and for vertical coma for 4-mm pupil (P<0.05).

CONCLUSION

Short-term scleral lens wear showed flattening of the anterior corneal surface in all subjects. In the KC group, the flattening was more pronounced in the nasal quadrant while changes were more pronounced inferiorly in KC-ICRS group.

摘要

目的

评估巩膜接触镜佩戴对圆锥角膜(KC)患者角膜前表面曲率和像差的影响,这些患者分为植入角膜内环(ICRS)组和未植入组。

方法

选取26例确诊为圆锥角膜的患者参与本研究。患者被分为两组,植入ICRS组(KC-ICRS组)和未植入ICRS组(KC组)。指导患者佩戴16.5毫米巩膜镜8小时。在佩戴镜片前及摘除镜片后立即评估地形图和像差参数。在角膜直径为2、4、6和8毫米处评估角膜前表面曲率,在瞳孔直径为4、6和8毫米处测量角膜像差。

结果

患者的平均年龄为36.95±8.95岁。在KC组,中央角膜曲率有统计学意义的变平,从6.98毫米变为7.09毫米(P<0.05)。KC-ICRS组中央角膜曲率未发现变化。KC组角膜前表面曲率变平,主要在鼻侧象限。KC-ICRS组主要在下半区变平。在KC组,6毫米瞳孔的球差显著增加。在KC-ICRS组,4毫米和6毫米瞳孔直径处的高阶均方根像差、4毫米和6毫米的斜向散光以及4毫米瞳孔的垂直彗差变化有统计学意义(P<0.05)。

结论

短期佩戴巩膜镜使所有患者的角膜前表面变平。在KC组,鼻侧象限变平更明显,而在KC-ICRS组,下半区变化更明显。

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