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巩膜镜在各种角膜疾病的韩国患者中的应用。

Scleral Lens Applications Focused on Korean Patients with Various Corneal Disorders.

机构信息

Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Korean J Ophthalmol. 2023 Apr;37(2):157-165. doi: 10.3341/kjo.2022.0164. Epub 2023 Mar 23.

Abstract

PURPOSE

We aimed to report on the clinical outcomes of scleral lens applications in Korean patients with various corneal disorders.

METHODS

This retrospective review was conducted for 62 eyes of 47 patients who had been fitted with scleral lenses for various corneal disorders. The patients were referred for inadequate spectacle-corrected visual acuity and rigid gas permeable (RGP) or soft contact lens intolerance. Uncorrected visual acuity, habitually corrected visual acuity, best lens-corrected visual acuity, topographic indices, keratometry indices, and lens parameters were evaluated.

RESULTS

Twenty-six eyes of 19 patients with keratoconus were enrolled. Other conditions included corneal scar (13 eyes of 12 patients), phlyctenules (three eyes), laceration (four eyes), chemical burn (one eye), keratitis (one eye), Peters' anomaly (one eye), fibrous dysplasia (one eye), ocular graft-versus-host disease (two eyes of one patient), irregular astigmatism (18 eyes of 12 patients), and corneal transplant status (five eyes of four patients). The mean topographic values of the eyes include flat keratometric value (43.0 ± 6.1 diopters [D]), steep keratometric value (48.0 ± 7.4 D), and astigmatism (4.9 ± 3.6 D). Of the eyes fitted with scleral lenses, best lens-corrected visual acuity (0.10 ± 0.22 logarithm of the minimum angle of resolution [logMAR]) was significantly better than the habitually corrected visual acuity (0.59 ± 0.62 logMAR, p < 0.001).

CONCLUSIONS

Scleral contact lenses are a good alternative for patients with corneal abnormalities and those who are intolerable to RGP contact lenses, resulting in both successful visual outcomes and patient satisfaction, especially concerning keratoconus, corneal scar, and corneal transplant status.

摘要

目的

本研究旨在报告在韩国患有各种角膜疾病的患者中应用巩膜镜的临床结果。

方法

本回顾性研究纳入了 47 名患者的 62 只眼,这些患者因各种角膜疾病而需要佩戴巩膜镜。患者因未矫正视力不达标、无法耐受硬性透气性(RGP)隐形眼镜或软性隐形眼镜而就诊。评估了未矫正视力、习惯性矫正视力、最佳镜片矫正视力、地形图指数、角膜曲率指数和镜片参数。

结果

26 只眼(19 名患者)为圆锥角膜,其他情况包括角膜瘢痕(12 名患者的 13 只眼)、疱疹性结节(3 只眼)、裂伤(4 只眼)、化学烧伤(1 只眼)、角膜炎(1 只眼)、Peters 异常(1 只眼)、纤维结构不良(1 只眼)、眼移植物抗宿主病(1 名患者的 2 只眼)、不规则散光(12 名患者的 18 只眼)和角膜移植状态(4 名患者的 5 只眼)。这些眼的平均地形图值包括平坦角膜曲率值(43.0 ± 6.1 屈光度 [D])、陡峭角膜曲率值(48.0 ± 7.4 D)和散光(4.9 ± 3.6 D)。在佩戴巩膜镜的眼中,最佳镜片矫正视力(0.10 ± 0.22 最小角分辨率对数[logMAR])明显优于习惯性矫正视力(0.59 ± 0.62 logMAR,p < 0.001)。

结论

巩膜接触镜是角膜异常和不能耐受 RGP 隐形眼镜患者的良好选择,不仅可以获得成功的视力结果,还可以提高患者满意度,特别是对于圆锥角膜、角膜瘢痕和角膜移植状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/380c/10151163/74584e59fa96/kjo-2022-0164f1.jpg

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