圆锥角膜患者长期配戴透气性硬性角膜接触镜对眼表的影响  

The effects of long term rigid gas permeable contact lens wear on ocular surface in keratoconus

作　　者：王志昕[1] 谢培英[1] 唐琰[1] 刘营[1] 郭曦[1] 

机构地区：[1]北京大学医学部眼视光学研究中心,100083

出　　处：《眼科》2008年第5期313-315,共3页Ophthalmology in China

摘　　要：目的观察圆锥角膜患者连续3年以上配戴透气性硬性角膜接触镜(RGPCL)对眼表的影响。设计回颐性病例系列。研究对象73例圆锥角膜患者。方法收集2001年7月～2004年7月在北京大学医学部眼视光学研究中心连续3年以上配戴RGPCL的73例患者(142眼),分别于戴镜前、戴镜1年、2年、3年用非接触式角膜内皮显微镜检测角膜内皮细胞密度及形态学改变;用A超角膜测厚仪测量眼轴长、中央及旁周边角膜厚度;定期复查,通过裂隙灯显微镜观察有无眼表并发症。主要指标角膜内皮细胞密度及形态学改变、角膜厚度、眼轴长、眼表改变。结果患者戴镜前、戴镜1年、2年、3年的角膜内皮细胞密度分别为(2901.92±445.20)个/mm^2、(2862.78±497.13)个/mm^2、(2854.71±526.80)个/mm^2、(3015.61±421.22)个/mm^2,差异无统计学意义(F= 1.571,P=0.20);其他形态学改变也均无统计学意义。眼轴长分别为(25.15±1.50)mm、(24.93±1.36)mm、(24.78±1.25)mm、(25.39±1.31)mm,差异无统计学意义(F=2.218,P=0.10)。中央角膜厚度分别为(489.09±59.64)μm、(484.02±60.80)μm、(496.61±59.74)μm、(487.44±54.25)μm,差异无统计学意义(F=0.991,P=0.40);旁周边角膜厚度的改变也均无统计学意义。随访期间裂隙灯检查发现轻度结膜充血69眼,角膜点染12眼,角膜上皮粗糙6眼,无其他异常表现。结论圆锥角膜患者科学合理地长期配戴RGPCL,不会引起显著的眼表异常变化,无明显的眼部并发症发生。Objective To investigate the effects of rigid gas permeable contact lens （RGPCL） wearing 3 years on ocular surface in keratoconus. Design Retrospective case series. Participants 73 patients with keratoconus. Methods From July 2001 to July 2004, 73 patients （142 eyes） wearing RGPCL for more than 3 years were collected in Peking University Optometry ＆ Ophthalmology Center. Be- fore and at 1 year, 2 years and 3 years of RGPCL wearing, density and morphologic changes of corneal endothelium were examined with non-contact specular microscope. Eye axial length, central and peripheral thickness of cornea were measured with A-scan pachymeter. All eyes were examined with slit-lamp microscope periodically. Main Outcome Measures Corneal endothelial density and morphology, corneal thickness, eye axial length, ocular surface changes. Results Before and at 1 year, 2 years and 3 years of RGPCL wearing, average corneal endothelial density was 2901.92±445.20, 2862.78±497.13, 2854.71±526.80, 3015.61±421.22 （cells/mm^2）without significant difference statistically （F=1.571, P=0.20）. Morphologic changes were not significant during 3 years. Eye axial length was 25.15±1.50, 24.93±1.36, 24.78±1.25, 25.39±1.31 （mm） without significant difference statistically （F=2.218, P=0.10）. Corneal central thickness was 489.09±59.64, 484.02±60.80, 496.61±59.74, 487.44±54.25（um）without significant difference statistically （F=0.991, P=0.40）. Peripheral thickness changes were also not significant statistically during 3 years. 69 eyes with mild conjunctival congestion, 12 eyes with corneal fluorescence stain and 6 eyes with corneal epithelial rough were found with slit-lamp microscope during follow-up. Conclusions For the patients with keratoconus, long term of RGPCL wear will not lead to significant ocular changes or severe ocular complications.

关 键 词：圆锥角膜 透气性硬性角膜接触镜 角膜厚度 角膜内皮细胞 

分 类 号：R772.21[医药卫生—眼科]