Lin Wei-Hsiang, Tsai Tsung-Hsien, Hsiao Ching-Hsi, Sun Chi-Chin, Lee Jiahn-Shing, Lin Ken-Kuo
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan.
Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan.
Medicina (Kaunas). 2025 Apr 15;61(4):728. doi: 10.3390/medicina61040728.
: Scleral lenses are widely used for visual rehabilitation in keratoconus patients, but their long-term effects on corneal tomography remain unclear. This study aims to evaluate the impact of 12-month scleral lens wear on corneal tomography in keratoconus patients through a case-controlled design. : This retrospective study included 220 keratoconus patients, of whom 10 eyes were treated with SoClear (Brighten Optix Corporation, Taipei, Taiwan) mini-scleral lenses for over one year (SL group). A control group of 14 eyes was matched using Mahalanobis distance matching based on anterior maximum keratometry (K) and age. Both groups were evaluated at baseline and 12 months. Corneal tomography was assessed using the Pentacam HR (Oculus, Wetzlar, Germany), analyzing parameters such as anterior and posterior corneal curvature, thinnest corneal thickness (TCT), and higher-order aberrations. Generalized estimating equations (GEEs) were employed to assess the time-by-treatment effect between the two groups. : The SL group included 10 eyes from eight patients (seven males, one female; mean age 30.40 ± 6.52 years), while the control group included 14 eyes from 11 patients (three males, wight females; mean age 27.43 ± 8.11 years). Best corrected visual acuity with spectacles improved significantly with scleral lenses ( = 0.011) and remained stable ( = 0.044) at 12 months. Significant interaction effects were found in Ambrósio relational thickness ( = 0.006), posterior radius curvature ( = 0.047), posterior mean keratometry ( = 0.019), posterior flat keratometry ( = 0.023), and thinnest corneal thickness angle ( = 0.023); the SL group demonstrated less progression in these parameters compared to the control group. : This case-controlled study highlights the 12-month impact of scleral lenses on keratoconus, showing improved visual acuity compared to spectacles, stabilized posterior corneal curvature, and maintained corneal thickness. Further prospective studies with larger cohorts are needed to assess scleral lens effect on keratoconus progression.
巩膜镜广泛应用于圆锥角膜患者的视力康复，但它们对角膜地形图的长期影响仍不清楚。本研究旨在通过病例对照设计评估圆锥角膜患者佩戴巩膜镜12个月对角膜地形图的影响。
本回顾性研究纳入了220例圆锥角膜患者，其中10只眼使用SoClear（台湾台北市Brighten Optix Corporation）迷你巩膜镜治疗超过一年（巩膜镜组）。基于前表面最大角膜曲率（K）和年龄，使用马氏距离匹配法匹配了14只眼作为对照组。两组均在基线和12个月时进行评估。使用Pentacam HR（德国韦茨拉尔市Oculus公司）评估角膜地形图，分析前、后角膜曲率、最薄角膜厚度（TCT）和高阶像差等参数。采用广义估计方程（GEEs）评估两组之间的时间-治疗效应。
巩膜镜组包括8例患者的10只眼（7例男性，1例女性；平均年龄30.40±6.52岁），而对照组包括11例患者的14只眼（3例男性，8例女性；平均年龄27.43±8.11岁）。佩戴巩膜镜后，最佳矫正视力显著提高（P = 0.011），并在12个月时保持稳定（P = 0.044）。在安布罗西奥相关厚度（P = 0.006）、后表面半径曲率（P = 0.047）、后表面平均角膜曲率（P = 0.019）、后表面平坦角膜曲率（P = 0.023）和最薄角膜厚度角度（P = 0.023）方面发现了显著的交互作用效应；与对照组相比，巩膜镜组这些参数的进展较小。
本病例对照研究突出了巩膜镜对圆锥角膜的12个月影响，显示与眼镜相比视力提高、后表面角膜曲率稳定且角膜厚度保持不变。需要进一步进行更大样本量的前瞻性研究来评估巩膜镜对圆锥角膜进展的影响。
