Aisien Faith, Di Meglio Laura, Bower Kraig, Crum Amanda
Lewis Katz School of Medicine at Temple University (F.A.), Philadelphia, PA; and Wilmer Eye Institute (L.D.M., K.B., A.C.), Baltimore, MD.
Eye Contact Lens. 2025 Apr 1;51(4):190-194. doi: 10.1097/ICL.0000000000001166. Epub 2025 Jan 22.
To determine if scleral fittings that occur before corneal cross-linking (CXL) are still successful after the procedure.
This prospective study included seven patients with keratoconus or post-laser-assisted in situ keratomileusis (LASIK) corneal ectasia who were fitted with scleral lenses then underwent CXL. Four patients (six eyes) had keratoconus and three patients (five eyes) had post-LASIK ectasia. Topographic and refractive parameters, as well as uncorrected visual acuity, best spectacle-corrected visual acuity, and scleral lens-corrected visual acuity were collected preoperatively and compared with values 1 and 3 months postoperatively.
Ten eyes had no significant change in refractive parameters from baseline to 3 months ( P >0.05). Nine eyes had no significant change in Km (mean keratometry), K2 (steep keratometry), Kmax (maximal corneal curvature), or pachymetry from baseline to 3 months ( P >0.05). On average, there was no significant difference regarding scleral lens or topographic measurements preoperatively versus postoperatively ( P >0.05).
On average, no significant differences were observed between preoperative and postoperative corneal measurements or refractive correction. These findings suggest that scleral fittings could be introduced before CXL to expedite the process of lens prescription and future acquisition. Safe scleral lens use with a lens fit before surgery could resume 1 month postoperatively.
确定在角膜交联（CXL）手术前进行的巩膜镜验配在手术后是否仍然成功。
这项前瞻性研究纳入了7例圆锥角膜患者或准分子激光原位角膜磨镶术（LASIK）后角膜扩张患者，他们先佩戴巩膜镜，然后接受CXL手术。其中4例患者（6只眼）患有圆锥角膜，3例患者（5只眼）患有LASIK术后角膜扩张。收集术前的地形图和屈光参数，以及未矫正视力、最佳矫正视力和巩膜镜矫正视力，并与术后1个月和3个月的值进行比较。
10只眼从基线到术后3个月屈光参数无显著变化（P>0.05）。9只眼从基线到术后3个月的平均角膜曲率（Km）、陡峭角膜曲率（K2）、最大角膜曲率（Kmax）或角膜厚度测量值无显著变化（P>0.05）。平均而言，术前与术后的巩膜镜或地形图测量值无显著差异（P>0.05）。
平均而言，术前和术后的角膜测量或屈光矫正之间未观察到显著差异。这些发现表明，可以在CXL手术前进行巩膜镜验配，以加快镜片处方和后续配镜过程。术后1个月可恢复安全使用术前验配的巩膜镜。
