Sidi Mohamed Hamida Abdelkader, Marta García-Barchín, Pedro Ruiz-Fortes, Piñero David P
Department of Ophthalmology, Torrecárdenas Hospital Complex, 04009, Almería, Spain.
Group of Optics and Visual Perception, Department of Optics, Pharmacology, and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, 03690, Alicante, Spain.
Eye Vis (Lond). 2022 Oct 6;9(1):39. doi: 10.1186/s40662-022-00310-5.
To investigate which factors are correlated with the visual improvement achieved with a specific model of scleral contact lens (SCL) in keratoconus (KC) eyes and to define a model to predict such improvement according to the pre-fitting data. In addition, the changes occurred with the fitting of a specific model of SCL during a period of 3 months in corneas with KC have been investigated.
Longitudinal retrospective study including 30 eyes of 18 patients (age, 14-65 years) with KC fitted with the SCL ICD16.50 (Paragon Vision Sciences). Visual, refractive, corneal tomographic and ocular aberrometric changes were evaluated during a 3-month follow-up. Likewise, the characterization of the post-lens meniscus was performed by optical coherence tomography (OCT) with the measurement of central, nasal and temporal vaults.
The visual acuity increased significantly from a mean pre-fitting value with spectacles of 0.23 ± 0.07 logarithm of minimal angle of resolution (logMAR) to a mean value of 0.10 ± 0.04 logMAR after 1 month of SCL wear (P < 0.001). An improvement of 1 or more lines of visual acuity with the SCL occurred in 62.1% of the eyes. A significant decrease in central, nasal, and temporal vault was observed after 1 month of SCL wear (P ≤ 0.046). Likewise, there was a significant difference between nasal and temporal vaults during the first month of SCL use (P = 0.008). Furthermore, a significant reduction of ocular high order (P = 0.028) and primary coma root mean square (P = 0.018) was found with the SCL. A predicting linear equation of the change in visual acuity achievable with the SCL was obtained (P < 0.001, R = 0.878) considering the pre-fitting spectacle corrected distance visual acuity, and the power and sagittal lens of SCL.
The scleral contact lens evaluated provides an efficacious visual rehabilitation in KC due to the improvement of visual acuity and the correction of low and high-order ocular aberrations. This visual acuity improvement can be predicted from some pre-fitting variables.
研究哪些因素与圆锥角膜（KC）眼使用特定型号巩膜接触镜（SCL）后的视力改善相关，并根据配镜前数据定义一个预测这种改善的模型。此外，还研究了KC角膜在佩戴特定型号SCL 3个月期间发生的变化。
纵向回顾性研究，纳入18例（年龄14 - 65岁）KC患者的30只眼，佩戴SCL ICD16.50（帕拉贡视觉科学公司）。在3个月的随访期间评估视力、屈光、角膜断层扫描和眼像差的变化。同样，通过光学相干断层扫描（OCT）测量晶状体后房中央、鼻侧和颞侧的房水弯月面来进行晶状体后房的特征描述。
佩戴SCL 1个月后，视力从配镜前平均眼镜矫正视力0.23±0.07最小分辨角对数（logMAR）显著提高到平均值0.10±0.04 logMAR（P < 0.001）。62.1%的眼睛使用SCL后视力提高了1行或更多行。佩戴SCL 1个月后，中央、鼻侧和颞侧房水弯月面显著降低（P≤0.046）。同样，在使用SCL的第一个月，鼻侧和颞侧房水弯月面之间存在显著差异（P = 0.008）。此外，使用SCL后，眼高阶像差（P = 0.028）和初级彗差均方根（P = 0.018）显著降低。考虑配镜前眼镜矫正远视力、SCL的屈光度和矢高，获得了使用SCL可实现的视力变化的预测线性方程（P < 0.001，R = 0.878）。
由于视力提高以及低阶和高阶眼像差的矫正，所评估的巩膜接触镜为KC患者提供了有效的视力康复。这种视力改善可以从一些配镜前变量进行预测。
