Clinical and Experimental Optometry Research Lab, Center of Physics, University of Minho, Braga, Portugal.
Eye-Contact-Lens Research and Education, Amsterdam, the Netherlands.
Optom Vis Sci. 2020 Sep;97(9):775-789. doi: 10.1097/OPX.0000000000001570.
This study shows the optical and visual quality behavior of modern scleral lenses (SLs) in the medium and long term in patients with irregular cornea (IC) and regular cornea (RC).
The purpose of this study was to evaluate the 12-month optical quality outcomes with SL in patients with IC and RC.
Sixty-nine patients completed the 12 months of follow-up (99 eyes with IC and 27 with RC). LogMAR high- and low-contrast visual acuity, whole eye aberrometry, and the size (Light Disturbance Index, %) and shape (BFCIrregSD, mm) of night vision disturbances were measured at baseline with habitual correction (HC), best spectacle correction (BSC), and SL at all the follow-up visits (1, 3, 6, and 12 months). Subjective visual quality was measured with the Quality of Vision (QoV) questionnaire.
After SL fitting, high-contrast visual acuity improved significantly compared with HC and BSC in the IC group (average improvement of +0.35 ± 0.32 and +0.29 ± 0.26 to +0.08 ± 0.14, P < .001) and RC group (+0.17 ± 0.23 and +0.12 ± 0.23 to +0.10 ± 0.23, P < .05). Light Disturbance Index decreased significantly with SL compared with HC and BSC from 13.85 ± 13.99% and 15.89 ± 13.38% to 5.75 ± 4.51% in the IC group (P < .001) and 6.16 ± 5.38 and 5.98 ± 5.39 to 3.99 ± 3.05 in the RC group (P < .05). BFCIrregSD also decreased significantly, namely, in the IC group (-51%). All subscales of the QoV questionnaire had a statistically significant decrease (improvement) with SL (P < .05).
Scleral lenses promote a better subjective and objective visual quality, mainly in patients with IC. Additional measurements such as night vision disturbances, aberrometry, and subjective perceptions should be considered to characterize the visual enhancement promoted by SL in RC and IC patients.
本研究旨在评估现代巩膜镜(SL)在角膜不规则(IC)和规则(RC)患者中的中、长期光学和视觉质量。
本研究旨在评估 IC 和 RC 患者使用 SL 的 12 个月光学质量结果。
69 例患者完成了 12 个月的随访(99 只眼 IC,27 只眼 RC)。使用习惯矫正(HC)、最佳矫正视力(BSC)和所有随访(1、3、6 和 12 个月)时的 SL 测量基础值时的 LogMAR 高、低对比度视力、全眼像差、夜间视觉障碍的大小(光干扰指数,%)和形状(BFCIrregSD,mm)。使用视觉质量问卷(QoV)测量主观视觉质量。
SL 矫正后,IC 组高对比度视力较 HC 和 BSC 显著提高(平均改善+0.35±0.32 和+0.29±0.26 至+0.08±0.14,P<.001)和 RC 组(+0.17±0.23 和+0.12±0.23 至+0.10±0.23,P<.05)。与 HC 和 BSC 相比,SL 治疗后 IC 组的光干扰指数显著降低(从 13.85±13.99%和 15.89±13.38%降至 5.75±4.51%,P<.001),RC 组(从 6.16±5.38%和 5.98±5.39%降至 3.99±3.05%,P<.05)。BFCIrregSD 也显著降低,即 IC 组(-51%)。QoV 问卷的所有子量表均有统计学意义的降低(改善)(P<.05)。
巩膜镜可提高主观和客观视觉质量,主要是在 IC 患者中。应考虑额外的测量,如夜间视觉障碍、像差和主观感知,以描述 RC 和 IC 患者中 SL 所促进的视觉增强。