Department of Ophthalmology, Recep Tayyip Erdogan University Medical Faculty, Islampasa Mah, 53020, Merkez, Rize, Turkey.
Int Ophthalmol. 2021 Jan;41(1):45-55. doi: 10.1007/s10792-020-01551-w. Epub 2020 Aug 27.
To investigate the effect of hybrid contact lenses (HCLs) on keratoconus (KCN) progression after accelerated transepithelial cross-linking (A-TE CXL).
Thirty-five eyes of 26 patients who preferred Ultrahealth HCLs for an optical correction after A-TE CXL formed the study group, and 45 eyes of 34 patients who preferred spectacle correction were age- and sex-matched to form the control group. Corrected distance visual acuity (CDVA), maximum keratometry, mean keratometry, apical posterior keratometry, cylindrical power, minimum corneal thickness, keratoconus vertex indices and curvature asymmetry indices obtained by Scheimpflug corneal topography were compared before, 6 and 12 months after the procedure. Anterior segment optic coherence tomography (AS-OCT) was performed to measure the apical corneal clearance of HCL-wearing patients.
The median pre-CXL CDVA value of the patients in the HCL group was logMAR 0.30 (0.20-1.0), and it was logMAR 0.30 (0.10-1.0) in the spectacle-corrected group. There was a significant increase in CDVA 6 and 12 months after CXL procedure in both groups (p < 0.001, 0.003, respectively). The median front curve asymmetry index (FCAsym) significantly improved after A-TE CXL in the HCL group. The pre-CXL and 12th-month topographic comparisons of the spectacle-corrected group revealed no significant difference. In addition, no significant difference was observed between topographic alterations of two groups (p > 0.05).
The CDVA significantly improved, and KCN progression was halted in patients wearing HCL 12 months after A-TE CXL. Besides, FCAsym indices can be considered for follow-up of the HCL-wearing patients as an assistive parameter to AS-OCT measurements.
研究混合隐形眼镜(HCL)在经加速角膜上皮交联术(A-TE CXL)后对圆锥角膜(KCN)进展的影响。
本研究纳入 26 例患者的 35 只眼,这些患者在 A-TE CXL 后选择 Ultrahealth HCL 进行光学矫正,形成研究组;纳入年龄和性别相匹配的 34 例患者的 45 只眼,这些患者选择眼镜矫正,形成对照组。比较两组患者治疗前、治疗后 6 个月和 12 个月的矫正远视力(CDVA)、最大角膜曲率、平均角膜曲率、角膜顶点后表面曲率、柱镜度数、角膜最薄点厚度、圆锥角膜顶点指数和角膜曲率非对称指数。采用眼前节光学相干断层扫描(AS-OCT)测量佩戴 HCL 患者的角膜顶点间隙。
HCL 组患者的术前 CDVA 中位数为 logMAR 0.30(0.20-1.0),眼镜矫正组为 logMAR 0.30(0.10-1.0)。两组患者在 CXL 术后 6 个月和 12 个月时的 CDVA 均显著提高(p<0.001,0.003)。HCL 组 A-TE CXL 后前表面曲线非对称指数(FCAsym)显著改善。眼镜矫正组在治疗前和第 12 个月的地形图比较中未发现显著差异。此外,两组之间的地形图改变也没有发现显著差异(p>0.05)。
A-TE CXL 后 12 个月,佩戴 HCL 的患者的 CDVA 显著提高,KCN 进展得到抑制。此外,FCAsym 指数可作为 AS-OCT 测量的辅助参数,用于 HCL 佩戴患者的随访。