Penbe Aysegul, Kanar Hatice Selen, Arsan Aysu Karatay, Kurna Sevda Aydın
Department of Ophthalmology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Health Science University, Semsi Denizer Caddesi, E-5, Kartal Istanbul 34890, Turkey.
Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, Health Science University, E-5, Icerenkoy 34752, Istanbul, Turkey.
Int J Ophthalmol. 2023 Jan 18;16(1):67-74. doi: 10.18240/ijo.2023.01.10. eCollection 2023.
To evaluate the efficacy of custom-made soft keratoconus (KC) lenses on corneal aberrations and photic phenomena in two different optical zones in patients with KC.
Sixty eyes of 42 patients with KC were examined at baseline and after fitting HydroCone (Toris K) soft silicone hydrogel lenses. Best spectacle-corrected visual acuity (BSCVA) and contact lens-corrected visual acuity (CLCVA) were recorded. Lower- and higher-order corneal aberrations (LOAs and HOAs) were measured with and without Toris K lenses and compared in central 4.5 mm and 7 mm zones. Mesopic pupil diameter and subjective photic phenomena were also assessed.
Mean CLCVA was significantly improved compared to BSCVA (<0.0001). Corneal curvature and refractive measurements were found to be significantly reduced by the use of Toris K lenses, except for posterior corneal curvature values. In the 4.5 mm central optical zone, all wavefront aberrations decreased significantly after lens fitting (<0.0001). In contrast, in the 7 mm (peripheral) optical zone, values for HOAs, spherical and residual aberrations, and optical path differences were increased, while LOAs, trefoil, and quadrifoil coefficients were decreased. The rate of photic phenomena was significantly higher in participants with a pupil size >6.00 mm (85.7%).
Toris K lenses provide good visual results and a significant reduction in central corneal aberrations in patients with KC but could cause an increase in peripheral aberrations. This practical and nonsurgical approach appears to be an effective method for the visual management of KC.
评估定制的软性圆锥角膜（KC）镜片对KC患者两个不同光学区角膜像差和光学现象的疗效。
对42例KC患者的60只眼在基线时以及佩戴HydroCone（Toris K）软性硅水凝胶镜片后进行检查。记录最佳眼镜矫正视力（BSCVA）和隐形眼镜矫正视力（CLCVA）。在佩戴和不佩戴Toris K镜片的情况下测量角膜低阶和高阶像差（LOAs和HOAs），并在中央4.5毫米和7毫米区域进行比较。还评估了中瞳孔直径和主观光学现象。
与BSCVA相比，平均CLCVA有显著改善（<0.0001）。发现使用Toris K镜片后角膜曲率和屈光测量值显著降低，但角膜后表面曲率值除外。在4.5毫米中央光学区，镜片佩戴后所有波前像差均显著降低（<0.0001）。相比之下，在7毫米（周边）光学区，HOAs、球差和残余像差以及光程差的值增加，而LOAs、三叶像差和四叶像差系数降低。瞳孔大小>6.00毫米的参与者中光学现象的发生率显著更高（85.7%）。
Toris K镜片为KC患者提供了良好的视觉效果，并显著降低了中央角膜像差，但可能导致周边像差增加。这种实用的非手术方法似乎是KC视觉管理的有效方法。
