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硬性透气性角膜接触镜对圆锥角膜患者形态学参数及视力相关生活质量的影响。

Effects of rigid gas permeable contact lens on morphological parameters and vision-related quality of life in keratoconus patients.

作者信息

Xu Yue, Wang Yun, Zhang Xiao-Feng

机构信息

Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215000, Jiangsu Province, China.

出版信息

Int J Ophthalmol. 2022 Nov 18;15(11):1772-1781. doi: 10.18240/ijo.2022.11.07. eCollection 2022.

Abstract

AIM

To evaluate the effect of rigid gas permeable contact lens (RGP-CL) on corneal morphological parameters and vision-related quality of life in keratoconus (KC) patients.

METHODS

Totally 57 eyes of 30 KC patients who were followed-up for more than two years, including 17 RGP wearers (32 eyes) and 13 non-wearers (25 eyes) were retrospectively analyzed. Initial medical history and corneal topography were collected at baseline. Corneal topography, corneal aberration, optical coherence tomography, and vision-related quality of life questionnaires were performed at the last follow-up.

RESULTS

According to corneal topography, increase of the flattest keratometric values was higher in RGP wearers than in non-wearers (=0.038). The morphological parameters, including symmetry index of front corneal curvature (=0.004) and Baiocchi-Calossi-Versaci index front (=0.047), were lower in RGP wearers than in non-wearers. Vertical coma was smaller in RGP wearers than non-wearers in 3.0, 5.0, 6.0, and 7.0 mm pupil diameters, respectively (<0.05). The environmental triggering domain of ocular surface disease index was worse in RGP wearers as compared to non-wearers (=0.003). At the last follow-up, there were no significant differences in constituent ratios of KC progression, corneal thickness topography, epithelial thickness topography, morphological parameters of corneal topography, and other questionnaire scores between the two groups (all >0.05).

CONCLUSION

Long-term use of RGP does not worsen KC but may cause corneal epithelial remodeling to increase symmetry of corneal anterior surface, reduce corneal vertical coma and improve visual quality. However, RGP wearing causes a slight decrease in vision-related quality of life. The occurrence of ocular surface symptoms is mainly associated with environmental triggering factors.

摘要

目的

评估硬性透气性角膜接触镜(RGP-CL)对圆锥角膜(KC)患者角膜形态参数及视力相关生活质量的影响。

方法

回顾性分析30例随访时间超过两年的KC患者的57只眼,其中包括17例RGP佩戴者(32只眼)和13例非佩戴者(25只眼)。在基线时收集初始病史和角膜地形图。在最后一次随访时进行角膜地形图、角膜像差、光学相干断层扫描以及视力相关生活质量问卷调查。

结果

根据角膜地形图,RGP佩戴者中最平坦角膜曲率值的增加高于非佩戴者(=0.038)。RGP佩戴者的形态学参数,包括角膜前表面曲率对称指数(=0.004)和前表面Baiocchi-Calossi-Versaci指数(=0.047),低于非佩戴者。在3.0、5.0、6.0和7.0mm瞳孔直径下,RGP佩戴者的垂直彗差分别小于非佩戴者(<0.05)。与非佩戴者相比,RGP佩戴者的眼表疾病指数的环境触发领域更差(=0.003)。在最后一次随访时,两组之间KC进展的构成比、角膜厚度地形图、上皮厚度地形图、角膜地形图的形态学参数以及其他问卷调查得分均无显著差异(均>0.05)。

结论

长期使用RGP不会使KC病情恶化,但可能导致角膜上皮重塑,增加角膜前表面对称性,减少角膜垂直彗差并改善视觉质量。然而,佩戴RGP会导致视力相关生活质量略有下降。眼表症状的发生主要与环境触发因素有关。

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Keratoconus: An updated review.圆锥角膜:更新综述。
Cont Lens Anterior Eye. 2022 Jun;45(3):101559. doi: 10.1016/j.clae.2021.101559. Epub 2022 Jan 4.
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Corneal crosslinking in keratoconus management.圆锥角膜治疗中的角膜交联术。
J Fr Ophtalmol. 2020 Dec;43(10):1078-1095. doi: 10.1016/j.jfo.2020.07.002. Epub 2020 Sep 21.
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Update on Contact Lens Treatment of Keratoconus.圆锥角膜角膜接触镜治疗的最新进展。
Turk J Ophthalmol. 2020 Aug 26;50(4):234-244. doi: 10.4274/tjo.galenos.2020.70481.
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Current perspectives in the management of keratoconus with contact lenses.角膜接触镜治疗圆锥角膜的现状。
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