Narayana Nethralaya, Bangalore, India.
Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia.
Ophthalmic Physiol Opt. 2021 Jul;41(4):664-672. doi: 10.1111/opo.12802. Epub 2021 Mar 26.
To quantify the effect of a single scleral lens design on visual acuity and ocular higher-order aberrations in eyes with post-LASIK ectasia, keratoconus and pellucid marginal degeneration (PMD) that could not achieve satisfactory vision with spectacles or soft contact lenses.
Forty-six eyes of 28 participants fitted with diagnostic scleral lenses (KeraCare) were analysed, including 19, 15 and 12 eyes with post-LASIK ectasia, keratoconus and PMD, respectively. Corrected distance visual acuity (CDVA) and ocular aberrations were measured prior to lens wear and during lens wear after 60 min of settling. An i-Trace aberrometer was used to determine aberrations over a 4.5 mm diameter pupil.
Before lens wear, the median (95% confidence interval) values across all groups were: CDVA 0.30 (0.30, 0.40) logMAR, spherical equivalent refraction -2.75 (-5.25, -2.12) D, cylindrical refraction 3.75 (2.50, 5.00) D, higher-order-root-mean-square error (HO-RMS) 0.90 (0.64, 1.03) μm and vertical coma co-efficient C(3,-1) -0.32 (-0.42, -0.12) μm. RMS coma of 0.52 (0.40, 0.74) μm was higher for the keratoconus group than for the other groups (p < 0.05). During lens wear, values improved considerably across all groups: CDVA 0.0 (0.0, 0.00) logMAR, spherical equivalent refraction -0.50 (-0.75, +0.50) D, cylindrical refraction 0.50 (0.00, 0.50) D, HO-RMS 0.32 (0.26, 0.42) μm and C(3,-1) +0.12 (+0.02, +0.19) μm (all p < 0.001 compared to pre-lens wear). While reduced significantly, RMS coma remained higher in the keratoconus group at 0.35 (0.31, 0.52) μm than in the post-LASIK ectasia and PMD groups at 0.17 (0.12, 0.21) μm and 0.07 (0.02, 0.46) μm, respectively (p < 0.05).
The KeraCare scleral contact lens reduced ocular aberrations and improved visual acuity in patients with post-LASIK ectasia, keratoconus and PMD. The sign of vertical coma changed in keratoconus and PMD.
定量评估单一巩膜镜片设计对 LASIK 后扩张、圆锥角膜和边缘性角膜营养不良（PMD）患者的视力和眼高阶像差的影响，这些患者使用眼镜或软性隐形眼镜无法获得满意的视力。
分析了 28 名参与者的 46 只眼睛，包括 19 只、15 只和 12 只 LASIK 后扩张、圆锥角膜和 PMD 眼。在佩戴镜片前和佩戴镜片 60 分钟后稳定时测量矫正远视力（CDVA）和眼像差。使用 i-Trace 像差仪测量 4.5mm 瞳孔直径的像差。
在所有组中，佩戴镜片前的中位数（95%置信区间）值分别为：CDVA 0.30（0.30，0.40）logMAR，等效球镜屈光度-2.75（-5.25，-2.12）D，柱镜屈光度 3.75（2.50，5.00）D，高阶均方根误差（HO-RMS）0.90（0.64，1.03）μm 和垂直彗差系数 C（3，-1）-0.32（-0.42，-0.12）μm。与其他组相比，圆锥角膜组的 RMS 彗差（0.52（0.40，0.74）μm）更高（p<0.05）。在佩戴镜片期间，所有组的数值均显著改善：CDVA 0.0（0.0，0.00）logMAR，等效球镜屈光度-0.50（-0.75，+0.50）D，柱镜屈光度 0.50（0.00，0.50）D，HO-RMS 0.32（0.26，0.42）μm 和 C（3，-1）+0.12（+0.02，+0.19）μm（与佩戴镜片前相比，均为 p<0.001）。虽然 RMS 彗差显著降低，但圆锥角膜组仍高于 LASIK 后扩张组和 PMD 组，分别为 0.35（0.31，0.52）μm、0.17（0.12，0.21）μm 和 0.07（0.02，0.46）μm（p<0.05）。
KeraCare 巩膜接触镜可降低 LASIK 后扩张、圆锥角膜和 PMD 患者的眼像差并提高视力。圆锥角膜和 PMD 的垂直彗差方向发生改变。
