Clinique Ophtalmologique Thiers (A.-S.M.), Bordeaux, France; Centre Ophtalmologique Vendôme (T.J.), Lyon, France; Department of Neuro-Ophthalmology (T.J.), Hôpital Pierre-Wertheimer, Bron, France; Department of Ophthalmology (R.M., T.C., C.B.), Pavillon C, Hôpital Edouard-Herriot, Lyon, France; Cabinet d'Ophtalmologie De La Vallée (C.F.), Ornans, France; and Faculté de médecine Lyon Sud (C.B.), Charles-Mérieux, rue du Grand-Revoyet, Oullins, France.
Eye Contact Lens. 2022 Aug 1;48(8):318-321. doi: 10.1097/ICL.0000000000000919. Epub 2022 Jun 29.
To evaluate the utility of the SPOT scleral lens (Oxygen Permeable Scleral Lens of Thonon; LAO, Thonon-les-Bains, France) in the management of the irregular cornea after refractive surgery.
We included 19 patients (35 eyes) with irregular corneas after refractive surgery. Patients were fitted with scleral lenses after the failure of conventional contact lenses adaptation. The ophthalmologic examination included measurement of best-corrected visual acuity (BCVA), slitlamp examination, and evaluation of ocular aberrations (Objective Scattering Index [OSI] and higher-order aberration [HOA]).
Scleral lens fitting increases significantly the BCVA from 0.33 (±0.25) to 0.08 (±0.13) LogMAR (P<0.001). There was also a significant decrease in Ocular Surface Disease Index from 66.2±22.8 to 42.4±18.9 (P<0.001). Ocular aberrations (OAs) are also significantly reduced by the scleral lenses, the mean OSI goes from 7.2 (±4.2) to 3.0 (±1.8) (P<0.001), OA from 2.58 (±1.34) to 1.98 μm (±2.31) (P=0.035), and HOA from 0.94 (±0.51) to 0.48 (±0.23) (P=0.0018).
Fitting with scleral lenses improves patients' optical and ocular surface problems. Scleral lens restores BCVA and the quality of life. Fitting with scleral lenses is an alternative to further surgery on these fragile eyes and is sometimes the only viable treatment option for the patient.
评估 SPOT 巩膜镜（法国托农莱班的 Thonon 透气巩膜镜；LAO）在屈光手术后不规则角膜管理中的应用。
我们纳入了 19 名（35 只眼）屈光手术后出现不规则角膜的患者。在常规隐形眼镜适配失败后，为这些患者适配巩膜镜。眼科检查包括最佳矫正视力（BCVA）测量、裂隙灯检查和眼像差评估（客观散射指数[OSI]和高阶像差[HOA]）。
巩膜镜适配可显著提高 BCVA，从 0.33（±0.25）提高至 0.08（±0.13）LogMAR（P<0.001）。眼表疾病指数（OSI）也从 66.2±22.8 降至 42.4±18.9（P<0.001），降幅显著。巩膜镜还可显著降低眼像差（OAs），OSI 均值从 7.2（±4.2）降至 3.0（±1.8）（P<0.001），OA 从 2.58（±1.34）降至 1.98μm（±2.31）（P=0.035），HOA 从 0.94（±0.51）降至 0.48（±0.23）（P=0.0018）。
巩膜镜适配可改善患者的光学和眼表问题。巩膜镜可恢复 BCVA 和生活质量。对于这些脆弱的眼睛，巩膜镜适配是进一步手术的替代方案，有时也是患者唯一可行的治疗选择。
