Marmara University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey.
Mustafa Kemal University Faculty of Medicine, Department of Ophthalmology, Hatay, Turkey.
Turk J Ophthalmol. 2020 Dec 29;50(6):339-342. doi: 10.4274/tjo.galenos.2020.56804.
To assess the visual performance of a mini-scleral lens in patients with keratoconus and to evaluate its fit by optical coherence tomography (OCT).
Twenty-nine eyes of 24 patients with keratoconus were fitted with a mini-scleral lens (Esclera; Mediphacos Inc., Belo Horizonte, Brazil). Diagnostic lenses were used in the initial fitting process. The lens fit was evaluated by the fluorescein pattern and also by anterior segment OCT (RTVue, Optovue Inc., Fremont, CA). Within 30-45 minutes after insertion, the lens fit parameters including central corneal and limbal clearance, and peripheral landing zone alignment were evaluated by OCT. High- and low-contrast visual acuity (VA), subjective performance for comfort and vision (5-point Likert scale), and overall satisfaction with the lens (100 mm visual analog scale [VAS]) were measured before and after lens wear.
The mean decimal high-contrast VA (best spectacle-corrected VA: 0.40±0.14 vs VA with the scleral lens: 0.93±0.12, p<0.0001) and low-contrast VA (best spectacle-corrected VA: 0.60±0.24 vs VA with the scleral lens: 1.15±0.18, p<0.0001) significantly improved with lens wear. The mean central corneal clearance was 120.7±24.5 μm. There were no correlations between the keratometric values and the sagittal depth of the scleral lens. The mean number of trial lenses required for ideal fit was 2.2 lenses (range: 1-8). Patients reported high scores for comfort (mean score: 4.69; range: 4-5), vision (mean score: 4.62; range: 3-5) and overall satisfaction with the lens (mean VAS score: 88.1; range: 70-100).
The mini-scleral lens provided good high- and low-contrast visual acuity and high patient satisfaction in patients with keratoconus. Anterior segment OCT imaging facilitated the evaluation of the fit.
评估角膜塑形镜在圆锥角膜患者中的视觉表现，并通过光学相干断层扫描（OCT）评估其适配性。
对 24 名圆锥角膜患者的 29 只眼进行了角膜塑形镜（巴西贝洛奥里藏特的 Mediphacos 公司的 Esclera）的适配。在初始适配过程中使用了诊断镜片。通过荧光素图案和眼前节 OCT（RTVue，美国弗里蒙特的 Optovue 公司）评估镜片适配情况。在插入后 30-45 分钟内，通过 OCT 评估镜片的中央角膜和角巩膜缘间隙、周边着陆区的对准度等适配参数。在佩戴镜片前后，分别测量高对比度和低对比度视力（最佳矫正视力：0.40±0.14 与角膜塑形镜视力：0.93±0.12，p<0.0001）、舒适度和视觉的主观表现（5 分李克特量表）以及对镜片的总体满意度（100 毫米视觉模拟量表 [VAS]）。
高对比度视力（最佳矫正视力：0.40±0.14 与角膜塑形镜视力：0.93±0.12，p<0.0001）和低对比度视力（最佳矫正视力：0.60±0.24 与角膜塑形镜视力：1.15±0.18，p<0.0001）均显著提高。中央角膜间隙平均为 120.7±24.5μm。角膜曲率值与巩膜镜的矢状深度之间无相关性。理想适配所需的试镜平均数量为 2.2 个（范围：1-8）。患者对舒适度（平均评分：4.69；范围：4-5）、视力（平均评分：4.62；范围：3-5）和对镜片的总体满意度（平均 VAS 评分：88.1；范围：70-100）的评分均较高。
角膜塑形镜为圆锥角膜患者提供了良好的高对比度和低对比度视力，并获得了较高的患者满意度。眼前节 OCT 成像有助于评估适配情况。
