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角膜硬性透气性接触镜佩戴过程中圆锥角膜眼的角膜断层影像学改变。

Corneal tomographic changes during corneal rigid gas-permeable contact lens wear in keratoconic eyes.

机构信息

Innovative Visual Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

出版信息

Br J Ophthalmol. 2022 Feb;106(2):197-202. doi: 10.1136/bjophthalmol-2020-317057. Epub 2020 Nov 10.

DOI:10.1136/bjophthalmol-2020-317057
PMID:33172864
Abstract

BACKGROUND/AIMS: We aimed to investigate the refractive changes in the posterior corneal surface in keratoconus (KC) associated with wearing spherical corneal rigid gas-permeable contact lenses (corneal GPs) with apical touch or three-point touch fitting and the effect of spherical corneal GPs on corneal biomechanics.

METHODS

Patients with KC wearing corneal GPs every day without facing complications were enrolled as a single group. Corneal tomographic data were obtained using a three-dimensional anterior segment optical coherence tomography from the same eye with and without corneal GPs. Dioptric data from the central 3-mm zone of the posterior corneal surface were decomposed into spherical, regular astigmatism, asymmetry and higher-order irregularity components using Fourier harmonic analysis. The corneal biomechanical indices were deformation amplitude ratio within 2 mm, integrated radius, stiffness parameter at first applanation and linear Corvis Biomechanical Index. Correlations between the difference in Fourier indices with and without corneal GPs and the corneal biomechanical parameters were analysed.

RESULTS

Thirty-two eyes of 32 patients with KC were enrolled. Spherical, regular astigmatism and asymmetry components were significantly smaller with corneal GP wear than without the wear (all p<0.001). All biomechanical indices were significantly correlated with the difference in the spherical components with and without corneal GPs.

CONCLUSION

Corneal biomechanical properties of KC were correlated with posterior corneal surface flattening induced by wearing corneal GPs on the spherical components. This effect is greater in biomechanically weaker corneas.

摘要

背景/目的:我们旨在研究圆锥角膜(KC)患者在佩戴顶点接触或三点接触式球形硬性透气性角膜接触镜(角膜 GPs)后,后角膜表面的屈光度变化以及角膜 GP 对角膜生物力学的影响。

方法

纳入每天佩戴角膜 GPs 且无并发症的 KC 患者作为单一组。使用三维眼前节光学相干断层扫描仪从前部同一眼中获取角膜 GP 有/无的角膜断层数据。使用傅里叶谐波分析将后角膜表面中心 3mm 区域的屈光度数据分解为球镜、规则散光、非对称和高阶不规则成分。角膜生物力学指标为 2mm 内的变形幅度比、整合半径、第一次压平的刚性参数和线性 Corvis 生物力学指数。分析角膜 GP 有/无的傅里叶指数差异与角膜生物力学参数之间的相关性。

结果

纳入 32 例 KC 患者的 32 只眼。与不佩戴角膜 GP 相比,佩戴角膜 GP 后球镜、规则散光和非对称成分明显更小(均 p<0.001)。所有生物力学指标均与角膜 GP 有/无的球镜成分差异显著相关。

结论

KC 的角膜生物力学特性与佩戴角膜 GP 引起的后角膜表面变平坦有关。在生物力学较弱的角膜中,这种影响更大。

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