Astin C L, Gartry D S, McG Steele A D
Moorfields Eye Hospital, London.
Br J Ophthalmol. 1996 Jul;80(7):597-603. doi: 10.1136/bjo.80.7.597.
AIMS/BACKGROUND: This study evaluated contact lens fitting and the longer term response of the photorefractive keratectomy (PRK) cornea to lens wear. In PRK for myopia problems such as regression, anterior stromal haze, irregular astigmatism, halo aberration, and anisometropia have been reported. Certain patients therefore require contact lens correction to obtain best corrected visual acuity (BCVA).
From an original cohort of 80 patients, 15 were dissatisfied with their visual outcome 6 months after PRK. Ten of these were fitted with lenses and monitored regularly.
The best fit rigid gas permeable lens of diameter 9.20-10.00 mm was generally 0.10 mm steeper than mean keratometry readings. Because of lid discomfort five patients were refitted with daily wear soft lenses. All 10 achieved satisfactory lens wear of 10 hours per day. Central corneal steepening of 0.75 D (0.15 mm) occurred in one patient. Two patients had slight central corneal flattening. Three patients discontinued lens wear as they found lens care a nuisance. Four finally opted for retreatment by PRK.
In most cases, contact lenses gave good visual acuity and, in cases of mild irregular astigmatism, a significant improvement over spectacle BCVA. No significant adverse reaction to contact lens wear was found. Although ocular tolerance of lenses was satisfactory, several patients discontinued lens wear or sought improved unaided vision.
目的/背景：本研究评估了角膜接触镜的适配情况以及准分子激光原位角膜磨镶术（PRK）角膜对镜片佩戴的长期反应。在治疗近视的PRK手术中，已报道出现诸如回退、前基质 haze、不规则散光、光晕像差和屈光参差等问题。因此，某些患者需要佩戴角膜接触镜来获得最佳矫正视力（BCVA）。
在最初的80例患者队列中，15例在PRK术后6个月对其视力结果不满意。其中10例佩戴了镜片并定期进行监测。
直径为9.20 - 10.00 mm的最佳适配硬性透气性镜片通常比平均角膜曲率读数陡0.10 mm。由于眼睑不适，5例患者改用日戴型软性角膜接触镜。所有10例患者每天佩戴镜片10小时均获得了满意的效果。1例患者出现中央角膜变陡0.75 D（0.15 mm）。2例患者中央角膜有轻微变平。3例患者因觉得镜片护理麻烦而停止佩戴镜片。4例最终选择再次接受PRK治疗。
在大多数情况下角膜接触镜能提供良好的视力，对于轻度不规则散光患者，其矫正视力比框架眼镜有显著提高。未发现佩戴角膜接触镜有明显不良反应。虽然镜片的眼耐受性良好，但仍有部分患者停止佩戴镜片或寻求提高裸眼视力。
