Massachusetts Eye & Ear, Cornea and Refractive Surgery Service, Harvard Medical School, Boston, MA, USA.
BostonSight, Needham, MA, USA.
Cont Lens Anterior Eye. 2021 Apr;44(2):289-329. doi: 10.1016/j.clae.2021.02.002. Epub 2021 Mar 25.
The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for such applications. There is consistent evidence that bandage soft contact lenses, particularly silicone hydrogel lenses, improve epithelial healing and reduce pain in persistent epithelial defects, after trauma or surgery, and in corneal dystrophies. Drug delivery applications of contact lens hold promise for improving topical therapy. Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment. This report offers a practical and relevant summary of the current evidence for the medical use of contact lenses for all eye care professionals including optometrists, ophthalmologists, opticians, and orthoptists. Topics covered include indications for use in both acute and chronic conditions, lens selection, patient selection, wear and care regimens, and recommended aftercare schedules. Prevention, presentation, and management of complications of medical use are reviewed.
接触镜在医学上的应用是解决许多复杂眼部疾病的方法，包括高度屈光不正、不规则散光、原发性和继发性角膜扩张、畸形疾病和眼表疾病。高透氧软性和硬性材料的发展扩展了接触镜在这些应用中的适用性。有一致的证据表明，绷带软性接触镜，特别是硅水凝胶镜片，可改善创伤或手术后以及角膜营养不良患者持续性上皮缺损的上皮愈合和减轻疼痛。接触镜的药物输送应用有望改善局部治疗。现代巩膜镜实践在视觉康复和治疗应用方面取得了巨大成功，包括需要保留泪液储备或免受不良环境影响的应用。本报告为所有眼科护理专业人员（包括验光师、眼科医生、配镜师和视轴矫正师）提供了接触镜在医学应用方面的当前证据的实用和相关总结。涵盖的主题包括在急性和慢性疾病中的使用指征、镜片选择、患者选择、佩戴和护理方案以及推荐的后续护理计划。还回顾了医学用途并发症的预防、表现和处理。
