Smiddy W E, Hamburg T R, Kracher G P, Stark W J
Contact Lens Service, Wilmer Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Ophthalmology. 1988 Apr;95(4):487-92.
The success rate of contact lens fitting and rate of progression to keratoplasty were evaluated for 115 consecutive patients with keratoconus. Of 190 nonoperated eyes that needed to be fit, 25 (13%) could not be fit, whereas 165 eyes (87%) could be fit. Most of these eyes had been referred for keratoplasty after previous contact lens fittings had no longer been successful. Of the 165 eyes that could be fit, 51 (31%) ultimately needed keratoplasty after an average of 38.4 months of lens wear, and 114 eyes (69%) did not require keratoplasty over an average follow-up interval of 63 months of wearing contact lenses. The average initial keratoplasty reading in these two groups was 56.8 and 51.8 diopters (D), respectively. Special design, bispheric lenses were required in 125 of these 165 eyes (76%) and frequent lens changes were necessary. Of 88 postoperative eyes, 53 (60%) wore contact lenses for best vision. Keratoplasty can be delayed or avoided in many keratoconus patients by using contact lenses, especially special design, bispheric lenses. Also, keratoconus eyes often need contact lenses after keratoplasty.
对115例连续性圆锥角膜患者的隐形眼镜适配成功率及角膜移植术进展率进行了评估。在190只需要适配的未手术眼中，25只（13%）无法适配，而165只眼（87%）可以适配。这些眼中大多数是在先前的隐形眼镜适配不再成功后被转诊进行角膜移植术的。在165只可以适配的眼中，51只（31%）在平均佩戴镜片38.4个月后最终需要角膜移植术，114只眼（69%）在平均随访63个月的隐形眼镜佩戴期内不需要角膜移植术。这两组的平均初始角膜移植术读数分别为56.8和51.8屈光度（D）。在这165只眼中，125只（76%）需要特殊设计的双球面镜片，并且需要频繁更换镜片。在88只术后眼中，53只（60%）佩戴隐形眼镜以获得最佳视力。通过使用隐形眼镜，尤其是特殊设计的双球面镜片，许多圆锥角膜患者的角膜移植术可以延迟或避免。此外，圆锥角膜眼在角膜移植术后通常也需要隐形眼镜。
