Formisano Martina, Franzone Federica, Alisi Ludovico, Pistella Santino, Spadea Leopoldo
Eye Clinic, Department of Sense Organs, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy.
Ther Clin Risk Manag. 2021 Jan 25;17:79-85. doi: 10.2147/TCRM.S293425. eCollection 2021.
To evaluate the visual acuity level achieved by scleral contact lens (CL) fitting in patients affected by keratoconus and to evaluate possible intraocular pressure (IOP) changes during the scleral CL wear using a transpalpebral tonometer.
In a prospective case series a comparison was made between visual acuity obtained with glasses, RGP and 16.8mm diameter scleral CL in 30 consecutive patients affected by keratoconus. IOP was tested during scleral CL wear by transpalpebral Diaton Tonometer (DT) and also by Goldmann Applanation Tonometer (GAT) before and after scleral CL wear.
The mean logMAR visual acuity improved from 0.2±0.25SD with glasses and 0.1±0.02SD with RGP, to -0.002±0.041SD when using the scleral CL (<0.05). The mean IOP value before scleral CL wear was 12.93mmHg±2.20SD when measured with GAT and 7.85mmHg±2.27SD when measured with DT. During scleral CL wear, IOP was assessed through DT, with a mean value of 8.86mmHg±2.36SD; values were stable after 8 hours of scleral CL use. Immediately after scleral CL removal, the mean IOP measured with GAT was 12.85mmHg ±2.40SD and the mean IOP measured with DT was 7.66mmHg±1.88SD. Therefore, during scleral CL wear, it was evidenced a small but statistically significant increase of the mean IOP value (1.01mmHg; <0.01), with a reversion to values prior to application when scleral CL was removed.
Scleral CLs remarkably improved visual acuity in keratoconus patients when compared to glasses or RGP contact lenses. Even if it was evidenced a small increase of the mean IOP value during their wear, it may not be significant in otherwise healthy eyes. Statistical analysis demonstrated good agreement between GAT and DT but their numerical values presented a constant gap, that should be taken into account when there is a need to relate the DT values to the reference ones.
评估圆锥角膜患者佩戴巩膜接触镜（CL）后的视力水平，并使用经睑眼压计评估巩膜CL佩戴期间眼内压（IOP）的可能变化。
在一项前瞻性病例系列研究中，对30例连续的圆锥角膜患者使用眼镜、RGP和直径16.8mm的巩膜CL所获得的视力进行了比较。在巩膜CL佩戴期间，通过经睑Diaton眼压计（DT）测量IOP，并且在巩膜CL佩戴前后还使用Goldmann压平眼压计（GAT）进行测量。
平均logMAR视力从佩戴眼镜时的0.2±0.25标准差和佩戴RGP时的0.1±0.02标准差，提高到使用巩膜CL时的-0.002±0.041标准差（<0.05）。巩膜CL佩戴前，用GAT测量的平均IOP值为12.93mmHg±2.20标准差，用DT测量为7.85mmHg±2.27标准差。在巩膜CL佩戴期间，通过DT评估IOP，平均值为8.86mmHg±2.36标准差；巩膜CL使用8小时后数值稳定。巩膜CL摘除后立即测量，用GAT测量的平均IOP为12.85mmHg±2.40标准差，用DT测量的平均IOP为7.66mmHg±1.88标准差。因此，在巩膜CL佩戴期间，平均IOP值有小幅但具有统计学意义的升高（1.01mmHg；<0.01），摘除巩膜CL后IOP恢复到佩戴前的值。
与眼镜或RGP隐形眼镜相比，巩膜CL显著提高了圆锥角膜患者的视力。即使在佩戴期间平均IOP值有小幅升高，但在其他方面健康的眼睛中可能并不显著。统计分析表明GAT和DT之间具有良好的一致性，但它们的数值存在恒定差距，在需要将DT值与参考值相关联时应予以考虑。
