Barone Vincenzo, Petrini Daniele, Nunziata Sebastiano, Surico Pier Luigi, Scarani Claudia, Offi Francesco, Villani Valentina, Coassin Marco, Di Zazzo Antonio
Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy.
Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy.
J Pers Med. 2024 Oct 11;14(10):1051. doi: 10.3390/jpm14101051.
Corneal ectasias, including keratoconus (KC), pellucid marginal degeneration (PMD), and post-LASIK ectasia, poses significant visual rehabilitation challenges due to the resultant irregular astigmatism, myopia, and higher-order aberrations (HOAs). These conditions often resist traditional corrective methods, necessitating advanced optical solutions. Scleral lenses (SLs) have emerged as a primary non-surgical option for managing these complex corneal irregularities. SLs form a smooth optical interface by forming a tear-filled chamber between the lens and the cornea, effectively mitigating HOAs and improving both high-contrast and low-contrast visual acuity (VA). This review evaluates the efficacy of SLs in enhancing VA and reducing aberrations in patients with corneal ectasia. It also explores the technological advancements in SLs, such as profilometry and wavefront-guided systems, which enable more precise and customized lens fittings by accurately mapping the eye's surface and addressing specific visual aberrations. The current body of evidence demonstrates that custom SLs significantly improve visual outcomes across various ectatic conditions, offering superior performance compared to conventional correction methods. However, challenges such as the complexity of fitting and the need for precise alignment remain. Ongoing innovations in SL technology and customization are likely to further enhance their clinical utility, solidifying their role as an indispensable tool in the management of corneal ectasias.
角膜扩张症，包括圆锥角膜（KC）、透明边缘变性（PMD）和准分子激光原位角膜磨镶术（LASIK）后角膜扩张，由于由此产生的不规则散光、近视和高阶像差（HOAs），给视力康复带来了重大挑战。这些病症往往对传统矫正方法有抵抗性，因此需要先进的光学解决方案。巩膜镜（SLs）已成为治疗这些复杂角膜不规则问题的主要非手术选择。巩膜镜通过在镜片和角膜之间形成一个充满泪液的腔室，形成一个光滑的光学界面，有效地减轻高阶像差，并提高高对比度和低对比度视力（VA）。这篇综述评估了巩膜镜在提高角膜扩张症患者视力和减少像差方面的疗效。它还探讨了巩膜镜的技术进步，如轮廓测量法和波前引导系统，这些技术通过精确绘制眼睛表面并解决特定的视觉像差，能够实现更精确和定制化的镜片适配。目前的证据表明，定制巩膜镜在各种扩张性病症中能显著改善视觉效果，与传统矫正方法相比性能更优。然而，诸如适配的复杂性和精确对准的需求等挑战仍然存在。巩膜镜技术和定制方面正在进行的创新可能会进一步提高其临床效用，巩固其作为角膜扩张症治疗中不可或缺工具的地位。
