软性虹彩片联合透气性半硬性角膜接触镜矫治外伤性无虹膜无晶状体眼  

Soft cosmetic contact lens combined with half-rigid gas permeable contact lens for traumatic aniridia and aphakia

作　　者：刘立洲[1] 吕燕云[1] 彭丽[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁隐形眼镜中心,100005

出　　处：《眼科》2011年第5期332-335,共4页Ophthalmology in China

摘　　要：目的评价软性虹彩片联合透气性半硬性角膜接触镜(RGPCL)对外伤性无虹膜无晶状体眼的矫治效果。设计回顾性病例系列。研究对象角膜内皮细胞密度在2500个/mm2以上外伤性无虹膜无晶状体眼患者59例(59眼)。方法患者联合戴用软性虹彩片和RGPCL,比较初诊时的插片视力和RGPCL矫正视力,随诊5年,非接触性角膜内皮计数仪检测角膜内皮细胞改变情况及裂隙灯下检查角结膜并发症情况。主要指标矫正视力,角膜内皮细胞计数,角结膜并发症。结果外伤性无虹膜无晶状体眼配戴软性虹彩片联合RGPCL的平均矫正视力(0.64±0.23)明显高于初诊时的插片视力(0.33±0.21),差异有统计学意义(t=7.750,P=0.000);畏光症状减轻;初诊时平均角膜内皮细胞计数为(2695.5±125.4)个/mm2(n=59),戴镜1、2、3、4、5年分别平均为(2705.4±145.6)个/mm2(n=43),(2639.5±146.7)个/mm2(n=30),(2625.5±143.6)个/mm2(n=26),(2641.5±168.5)个/mm2(n=32),(2638.2±128.6)个/mm2(n=29),第5年与初诊相比平均减少(70.3±8.7)个/mm2。角膜、结膜未见严重并发症。结论软性虹彩片联合RGPCL对角膜内皮细胞密度在2500个/mm2以上的外伤性无虹膜无晶状体眼在提高视力和解决畏光方面是一种有效方法,但要定期复查角结膜情况。Objective To investigate the clinical effects of soft cosmetic contact lens combined with half-rigid gas permeable con-tact lens（RGPCL） for traumatic aniridia and aphakia.Design Retrospective case series.Participants 59 patients（59 eyes） with trau-matic aniridia and aphakia,whose corneal endothelial cell density was above 2500 cells/mm2.Methods 59 patients（59 eyes） fitted with soft cosmetic contact lens combined with RGPCL were followed up for 5 years.The corrected visual acuity was compared between con-tact lens group and glasses group.The corneal endothelial changes were observed.The complications in cornea and conjunctiva were observed using slit-lamp examination.Main Outcome Measures Corrected visual acuity,corneal endothelial cells density and the com-plications of cornea and conjunctiva.Results The mean corrected visual acuity with glasses and with contact lens was（0.33±0.21） and（0.64±0.23）,respectively.The patients with soft cosmetic combined with RGPCL got better corrected visual acuity（t=7.750,P=0.000） and reduction in photophobia compared with those with glasses.The corneal endothelial cell density at baseline was（2695.5±125.4） cells/mm2（n=59）.One year,2 years,3 years,4 years and 5 years later it was（2705.4±145.6） cells/mm2（n=43）,（2639.5±146.7） cells/ mm2（n=30）,（2625.5±143.6） cells/mm2（n=26,）（2641.5±168.5） cells/mm2（n=32）,and（2638.2±128.6） cells/mm2（n=29,） respective-ly.The mean corneal endothelial cell density decreased（70.3±8.7） cells/mm2 in the 5 years.There were no severe complications in cornea and conjunctiva.Conclusions The soft cosmetic contact lens combined with RGPCL are effective for the patients with traumatic aniridia combined with aphakia,whose corneal endothelial cell density is more than 2500 cells/mm2.We should observe these patients for potential complications in cornea and conjunctiva

关 键 词：角膜接触镜 软性虹彩片 透气性半硬性接触镜 外伤性无虹膜 外伤性无晶状体眼 

分 类 号：R779.6[医药卫生—眼科]