Department of Ophthalmology (D.K., C.K.), Antwerp University Hospital, Antwerp, Belgium ; Department of Ophthalmology (D.K., C.K., E.O.K.), Faculty of Medical Sciences, University of Antwerp, Antwerp, Belgium ; Department of Ophthalmology (E.O.K.), Ghent University Hospital, Ghent, Belgium; and Department of Ophthalmology (E.O.K.), Faculty of Medical Sciences, Ghent University, Ghent, Belgium.
Eye Contact Lens. 2021 May 1;47(5):283-287. doi: 10.1097/ICL.0000000000000738.
To report the clinical outcome of hybrid contact lens fitting in keratoconus.
A retrospective chart review was performed of keratoconus patients who had been fitted with hybrid contact lenses in one or both eyes. Patients with a history of previous intraocular surgery (except for corneal crosslinking) and relevant concurrent ocular disease limiting visual outcome were excluded. The outcome data at 6-month follow-up included hybrid lens-corrected visual acuity, wearing time, and lens discontinuation.
Fifty-four keratoconus patients (102 eyes) were included. Mean visual acuity with habitual correction before hybrid lens fitting was 0.63±0.29 (decimal Snellen). Eyes were fitted with Eyebrid lenses (LCS Laboratories, Caen, France) and SynergEyes lenses (SynergEyes Inc., Carlsbad, CA). Refits were necessary in 13 eyes, because of poor fitting (76.9%) or suboptimal refraction (23.1%). Visual acuity had significantly improved with hybrid lenses (0.93±0.14; P<0.0001). In 37 eyes (37.8%), hybrid lens wear was discontinued within 6 months after lens fitting. Reported issues were discomfort in 27 eyes (73%), handling difficulties in 14 eyes (37.8%) and poor vision in 1 eye (2.7%). Success rate of lens fitting was significantly correlated to cone morphology (P=0.01).
New generation hybrid lenses are an appropriate, safe therapeutic option for keratoconus patients. Excellent visual outcomes are achieved in successful fittings, yet a dropout rate of 37.8%-mainly occurring in sagging, more peripheral, cones - still limit their clinical success.
报告圆锥角膜患者配戴混合隐形眼镜的临床效果。
对在一只或两只眼中配戴混合隐形眼镜的圆锥角膜患者进行回顾性图表分析。排除有既往眼内手术史（除角膜交联术外）和影响视力预后的相关并存眼病的患者。6 个月随访时的结局数据包括混合镜矫正视力、佩戴时间和镜片停用情况。
共纳入 54 例（102 只眼）圆锥角膜患者。在配戴混合隐形眼镜前的习惯矫正视力平均值为 0.63±0.29（十进制 Snellen）。这些眼分别配戴 Eyebrid 镜片（LCS 实验室，法国卡昂）和 SynergEyes 镜片（SynergEyes 公司，加利福尼亚州卡尔斯巴德）。因适配不良（76.9%）或屈光度不理想（23.1%），13 只眼需要重新配镜。与配戴混合隐形眼镜前相比，视力明显提高（0.93±0.14；P<0.0001）。在 37 只眼中（37.8%），在配镜后 6 个月内停止使用混合隐形眼镜。报告的问题包括 27 只眼（73%）不适、14 只眼（37.8%）处理困难和 1 只眼（2.7%）视力不佳。镜片适配成功率与圆锥形态显著相关（P=0.01）。
新一代混合隐形眼镜是圆锥角膜患者的一种合适、安全的治疗选择。在成功适配的患者中可获得良好的视力结果，但 37.8%的停戴率（主要发生在下垂、更外周的圆锥）仍然限制了其临床应用。
