The Ohio State University, College of Optometry, Columbus, Ohio.
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
Optom Vis Sci. 2020 Sep;97(9):711-719. doi: 10.1097/OPX.0000000000001574.
As scleral lens wear becomes more common, understanding the impact of these lenses upon ocular physiology is critically important. Studies on the effect of scleral lens wear upon intraocular pressure (IOP) have used different instruments and have reported conflicting results.
The purpose of this study was to compare assessment of IOP during scleral lens wear using pneumatonometry and transpalpebral tonometry.
Twenty healthy subjects wore a small-diameter (15.2 mm) and a large-diameter (18.0 mm) scleral lens on the right eye, each for 1 hour in randomized order. IOP was assessed with pneumatonometry and transpalpebral tonometry on both eyes before lens application, immediately after lens application, after 1 hour of lens wear, and immediately after lens removal. Paired t test compared mean IOP in the study eye to the control eye. Repeated-measures ANOVA was performed to take instrumentation, lens diameter, and their interaction into account in an analysis of the change in IOP in the study eye.
Mean peripheral IOP measured with pneumatonometry was not significantly different from baseline at any subsequent measurement. Measurements with transpalpebral tonometry, however, were significantly different during scleral lens wear immediately after application and after 1 hour of wear with both diameter lenses (P < .005), but were not significantly different after either sized lens was removed. Repeated-measures ANOVA revealed that the instrument used to measure IOP was a significant factor in IOP changes found during lens wear (P ≤ .001).
Assessment of IOP during scleral lens wear varies based upon the instrument that is used. Although further studies are clearly needed to further elucidate this issue, clinicians should continue to monitor optic nerve structure and function in scleral lens wearers, as they do in all patients.
随着巩膜镜佩戴变得越来越普遍，了解这些镜片对眼部生理学的影响至关重要。关于巩膜镜佩戴对眼压（IOP）影响的研究使用了不同的仪器，并报告了相互矛盾的结果。
本研究旨在比较气动眼压计和经皮眼压计评估巩膜镜佩戴时的眼压。
20 名健康受试者右眼依次佩戴小直径（15.2mm）和大直径（18.0mm）巩膜镜，每种镜片各佩戴 1 小时，随机进行。在应用镜片前、应用后即刻、佩戴 1 小时后和移除镜片后即刻，用气动眼压计和经皮眼压计评估双眼的眼压。配对 t 检验比较研究眼和对照眼的平均眼压。重复测量方差分析考虑仪器、镜片直径及其相互作用，分析研究眼眼压的变化。
用气动眼压计测量的周边眼压在任何后续测量中均与基线无显著差异。然而，经皮眼压计测量的眼压在应用后即刻和佩戴 1 小时后两种直径的镜片时均显著不同（P<0.005），但在移除任何一种直径的镜片后均无显著差异。重复测量方差分析显示，用于测量眼压的仪器是镜片佩戴期间眼压变化的一个重要因素（P≤0.001）。
巩膜镜佩戴期间的眼压评估因所使用的仪器而异。尽管显然需要进一步的研究来进一步阐明这个问题，但临床医生应该继续监测巩膜镜佩戴者的视神经结构和功能，就像他们监测所有患者一样。
