巩膜镜佩戴前后的角膜表面润湿性和泪膜稳定性。

Corneal surface wettability and tear film stability before and after scleral lens wear.

机构信息

Department of Optics II (Optometry and Vision), Faculty of Optic and Optometry, Universidad Complutense de Madrid, Madrid, Spain.

出版信息

Cont Lens Anterior Eye. 2019 Oct;42(5):520-525. doi: 10.1016/j.clae.2019.04.001. Epub 2019 Apr 6.

DOI:10.1016/j.clae.2019.04.001

PMID:30967331

Abstract

PURPOSE

The aim of this study was to evaluate the anterior surface of scleral contact lens and ocular surface wettability before and after one-month of scleral lens wear in patients with keratoconus.

METHODS

Forty-nine patients with keratoconus (36.26 ± 9.03 years) were recruited. The sample was divided into two groups: patients with intrastromal corneal ring (KCICRS group) and patients without ICRS (KC group). TFSQ, Schirmer I test, Ocular Surface Disease Index (OSDI questionnaire), tear break-up time (TBUT) and corneal staining were evaluated in two different visits: Baseline (before lens wear) and one-month visit (10 min after lens removal). Visual Analog Scale (VAS questionnaire) was filled in just after inserting the lenses and just before removing them. TFSQ mean and inferior were evaluated over the contact lens surface at the moment of inserting the lens (baseline visit) and after 8 h of lens wear (one-month visit).

RESULTS

Anterior corneal surface TFSQ values increased in all groups after scleral lens wear (p < 0.05). However, there were no statistical differences found at the moment of inserting or after 8 h of lens wear on previous contact lens surface TFSQ (p > 0.05). No changes were found in tear volume for total and in KC and KCICRS groups (p > 0.05). For all groups, there was a statistical decrease of TBUT (p < 0.05). In addition, OSDI score, corneal staining and VAS score improved after scleral lens wear from baseline in total and in both KC and KCICRS groups (p < 0.05).

CONCLUSION

The scleral contact lens surface keeps its wettability after one-month of wear. However, the wettability of the ocular surface is worse after contact lens wearing.

摘要

目的

本研究旨在评估圆锥角膜患者佩戴巩膜接触镜前后一个月的巩膜接触镜前表面和眼表面润湿性。

方法

招募了 49 名圆锥角膜患者（36.26±9.03 岁）。将样本分为两组：基质内角膜环（KCICRS 组）和无 ICRS 患者（KC 组）。在两次就诊时评估 TFSQ、泪液分泌试验、眼表疾病指数（OSDI 问卷）、泪膜破裂时间（TBUT）和角膜染色：基线（戴镜前）和一个月就诊（摘镜后 10 分钟）。视觉模拟量表（VAS 问卷）在插入镜片后和取出镜片前立即填写。在插入镜片时（基线就诊）和佩戴 8 小时后（一个月就诊）评估接触镜表面的角膜前表面 TFSQ 平均值和下值。

结果

所有组在佩戴巩膜接触镜后前角膜表面 TFSQ 值均增加（p<0.05）。然而，在插入镜片时或佩戴 8 小时后，先前接触镜表面 TFSQ 没有发现统计学差异（p>0.05）。在 KC 和 KCICRS 组中，泪液总量和 KC 组的泪液体积均无变化（p>0.05）。对于所有组，TBUT 均有统计学下降（p<0.05）。此外，在 KC 和 KCICRS 组中，OSDI 评分、角膜染色和 VAS 评分在佩戴巩膜接触镜后均从基线开始改善（p<0.05）。