Macedo-de-Araújo Rute J, Seco Rita Maria, González-Méijome José M
Clinical & Experimental Optometry Research Lab (CEORLab), University of Minho, Braga, Portugal; Physics Center of Minho and Porto Universities (CF-UM-UP), Braga, Portugal.
Clinical & Experimental Optometry Research Lab (CEORLab), University of Minho, Braga, Portugal; Physics Center of Minho and Porto Universities (CF-UM-UP), Braga, Portugal.
Cont Lens Anterior Eye. 2023 Dec;46(6):102067. doi: 10.1016/j.clae.2023.102067. Epub 2023 Oct 18.
To investigate the long-term influence of scleral lens (SL) wear on corneal biomechanical properties and intraocular pressure (IOP) in irregular and regular corneas. Secondary goal comprised evaluate the fluid reservoir (FR) thickness overtime and correlate it with the changes in corneal biomechanical parameters and IOP.
Seventy (70) eyes with irregular corneas (IC Group) and 21 eyes with regular corneas (RC Group) were fitted with 16.4 mm SL and wore the lenses for 12 months. Corrected IOP (IOPcc), Goldmann equivalent IOP (IOPg) and corneal biomechanical parameters (Corneal Hysteresis (CH) and Corneal Resistance Factor (CRF)) were measured with Ocular Response Analyzer. Slit lamp images were analyzed with ImageJ software to assess FR thickness overtime. Measurements were taken at lens dispensing visit prior lens wear (LDV1) and after 60 min of lens wear (LDV2) and at 1, 6 and 12-month follow-up visits. Measurements were done immediately after lens removal.
There were no statistically significant differences on IOPcc, IOPg, CRF and CH over the follow-up visits in both groups. Mean IOPcc and IOPg fluctuations overtime were clinically insignificant and below 1 mmHg in both groups. IOPg, CH and CRF were significantly lower on IC Group (p < 0.001), although no statistically significant differences were found between groups for IOPcc. Regarding FR thickness, statistically significant differences were found over the follow-up on both groups, with a mean decrease of 186.29 µm on IC Group and 175.32 µm on RC Group (p < 0.001). Statistically significant moderate to high negative correlations between FR and IOPg, CRF and CH were found only in the RC Group.
Long-term SL wear was not associated to changes in corneal biomechanical parameters neither on IOP as measured after lens removal. Besides IOP measurement without SL removal, more studies are needed to investigate the potential relationship with SL fitting characteristics (namely FR thickness).
探讨巩膜镜（SL）佩戴对不规则角膜和规则角膜的角膜生物力学特性及眼压（IOP）的长期影响。次要目标包括评估随时间变化的泪液储备（FR）厚度，并将其与角膜生物力学参数和眼压的变化相关联。
70只患有不规则角膜的眼睛（IC组）和21只患有规则角膜的眼睛（RC组）佩戴16.4毫米的巩膜镜，并佩戴12个月。使用眼反应分析仪测量校正眼压（IOPcc）、Goldmann等效眼压（IOPg）和角膜生物力学参数（角膜滞后量（CH）和角膜阻力因子（CRF））。使用ImageJ软件分析裂隙灯图像，以评估随时间变化的FR厚度。在配镜前（LDV1）、佩戴镜片60分钟后（LDV2）以及1、6和12个月的随访时进行测量。测量在镜片摘除后立即进行。
两组随访期间IOPcc、IOPg、CRF和CH均无统计学显著差异。两组随时间变化的平均IOPcc和IOPg波动在临床上无显著意义，且均低于1mmHg。IC组的IOPg、CH和CRF显著更低（p < 0.001），尽管两组间IOPcc无统计学显著差异。关于FR厚度，两组随访期间均存在统计学显著差异，IC组平均减少186.29μm，RC组平均减少175.32μm（p < 0.001）。仅在RC组中发现FR与IOPg、CRF和CH之间存在统计学显著的中度至高度负相关。
长期佩戴巩膜镜与镜片摘除后测量的角膜生物力学参数变化或眼压变化无关。除了不摘除巩膜镜测量眼压外，还需要更多研究来探讨与巩膜镜适配特征（即FR厚度）的潜在关系。
