角膜接触镜对圆锥角膜眼角膜生物力学参数的影响。

Impact of Corneoscleral Contact Lens Usage on Corneal Biomechanical Parameters in Keratoconic Eyes.

机构信息

Department of Optics, Optometry and Vision Sciences (E.P., J.C.M.), Physics College, University of Valencia, Burjassot, Valencia, Spain; Department of Surgery (E.E.-G.), Ophthalmology Unit, la Fe University and Polytechnic Hospital, Faculty of Medicine and Odontology, University of Valencia, Hospital la Fe, Valencia, Spain; and FISABIO Oftalmología Médica (C.P.-M.), Cornea Unit and Anterior Segment Diseases, Catholic University of Valencia, Valencia, Spain.

出版信息

Eye Contact Lens. 2019 Sep;45(5):318-323. doi: 10.1097/ICL.0000000000000579.

DOI:10.1097/ICL.0000000000000579

PMID:30747729

Abstract

OBJECTIVE

To analyze the changes in corneal biomechanical parameters of keratoconic eyes with and without intracorneal ring segment (ICRS) implants after 1 year of corneoscleral contact lens (CScL) wear.

METHODS

Seventy-four eyes of 74 patients were divided into three groups: healthy subjects (29 eyes, control group), and 2 groups of subjects with keratoconic eyes (one group of 20 eyes with ICRS implants and one of 25 eyes without them), which were fitted with CScL. Corneal hysteresis (CH), corneal resistance factor (CRF), and corneal-compensated intraocular pressure (IOPcc) were evaluated before fitting CScL and after 1 year of CScL wear. In addition, endothelial cell count (ECC) and central corneal thickness (CCT) were also recorded.

RESULTS

Corneal biomechanical parameters were lower in keratoconic corneas than in healthy corneas. Keratoconic eyes with ICRS implants had lower values than eyes without them for CH (mean±SD, 8.09±1.29 vs. 8.63±1.5 mm Hg, respectively, P=0.120), CRF (6.99±1.38 vs. 8.37±1.52 mm Hg, respectively, P=0.03), and also for CCT and ECC. Data for IOPcc were similar in all groups. After 1-year wearing CScL, no statistically significant differences in corneal biomechanical parameters were registered in any of the groups (all P>0.05), although slight differences (0.13-0.27 mm Hg) were found.

CONCLUSION

The viscoelasticity properties of the cornea did not change significantly when wearing corneoscleral contact lenses for 1 year, and therefore, these lenses seem to be safe and healthy and are a reasonable alternative option for keratoconus management.

摘要

目的

分析佩戴巩膜接触镜 1 年后，伴或不伴角膜内环段植入的圆锥角膜眼的角膜生物力学参数变化。

方法

74 例（74 只眼）患者的眼部分为 3 组：健康受试者（29 只眼，对照组）、伴圆锥角膜眼组（其中植入角膜内环段 20 只眼，未植入 25 只眼），均佩戴巩膜接触镜。在佩戴巩膜接触镜前及佩戴 1 年后，评估角膜滞后量（CH）、角膜阻力因子（CRF）和角膜补偿眼压（IOPcc）。此外，还记录内皮细胞计数（ECC）和中央角膜厚度（CCT）。

结果

与健康角膜相比，圆锥角膜的角膜生物力学参数较低。植入角膜内环段的圆锥角膜眼的 CH（分别为 8.09±1.29 和 8.63±1.5 mm Hg，P=0.120）、CRF（分别为 6.99±1.38 和 8.37±1.52 mm Hg，P=0.03）以及 CCT 和 ECC 值均低于未植入者。各组的 IOPcc 数据相似。佩戴巩膜接触镜 1 年后，各组的角膜生物力学参数均无统计学差异（均 P＞0.05），尽管略有差异（0.13-0.27 mm Hg）。