硬性高透氧性角膜接触镜矫正外伤性角膜散光应用研究  

Application study of rigid gas permeable contact lens in patients with traumatic corneal irregular astigmatism

作　　者：郑斌[1] 陈岩[1] 周静[1] 徐朝霞[1] 沈丽君[1] 

机构地区：[1]温州医学院附属眼视光医院,325000

出　　处：《中国实用眼科杂志》2012年第5期526-531,共6页Chinese Journal of Practical Ophthalmology

基　　金：温州市科技局科技计划项目（Y20100121）

摘　　要：目的探讨硬性高透氧性角膜接触镜（rigid gas permeable contact lens，RGPCL）矫正外伤性角膜散光患者视力的临床应用价值。方法对连续收集的18例眼前段外伤患者实施RGPCL验配，随访6个月以上。配戴前记录项目：年龄、性别、眼别、RGPCL验配与角膜拆线的间隔时间、晶状体状态、裸眼视力、框架镜矫正视力、伤口的大小位置、角膜前表面散光值。配戴后观察项目：RGPCL矫正视力、坚持戴镜时间、停戴原因、眼部并发症、长期配戴成功与否。长期配戴成功定义为在随访期间能坚持长期舒适配戴时间≥8h／d。视力转换成五分制进行统计。采用SPSS16．0软件系统。运用配对资料t检验、独立样本t检验和协方差分析进行数据统计。结果患者年龄5～45（20．94±13．35）岁，人工晶状体眼5只眼，无晶状体眼1只眼，其余12只眼为有晶状体眼。根据伤口位置，1区9只眼，2区9只眼。角膜伤口大小为1．50—8．33（4．04±2．23）mm，1区和2区之间伤口大小无统计学意义（t=-0．967，P=0．348）。RGPCL验配与角膜拆线的间隔时间3～22个（5．67±5．52）月。裸眼视力3．0-4．9（4．2±0．5），框架眼镜矫正视力4．0～4．9（4．6±0.3），RGPCL矫正视力4．4～5．1（4．9±0．1）。RGPCL较框架镜矫正视力明显提高（t=4．143，P〈0．000）。RGPCL较框架眼镜矫正视力提高1行7只眼，2～4行6只眼，≥5行4只眼。角膜分区伤口之间，RGPCL矫正视力差异无统计学意义（F=0．826，P=0．379），与框架镜矫正视力差异显著有统计学意义（F=5．128，P=0．040），RGPCL较框架镜矫正视力提高幅度差异显著有统计学意义（F=7．286，P=0．017）。伤口大小对RGPCL矫正视力、框架镜矫正视力、裸眼视力及视力提高幅度等均无显著影响。随访期间，患者均未出现习惯性镜片脱落，2只眼发生点状角膜上皮炎。长期配戴成功患�Objective To evaluate the clinical value of rigid gas permeable contact lens （RGP- CL） in patients with traumatic corneal irregular astigmatism. Methods Eighteen consecutive patients （18 eyes） with traumatic corneal irregular astigmatism were fitted RGPCL. All patients were fol- lowed up at least 6 months. Preoperative data included： age, sex, eye, interval between RGPCL fitting and complete sutures removal, status of lens, uncorrected visual acuity （UCVA）, spectacle visual acuity （SVA）, location and size of the corneal scar, corneal astigmatism. Post-contact lens fitting data included： RGPCL visual acuity （RGPCLVA）, duration of contact lens wear, the reason for dropping out of contact lens wear, contact lens-related complications, whether or not the patient was successful in wearing the contact lens. RGPCL fitting was considered successful if the patient judged the wearing of RGPCL to be satisfactory enough at least 8 hours of daily wear throughout the fol- low-up period. Decimal acuity was converted to 5-1ogMAR value. Data analysis used SPSS 16.0 for the paired samples t-test, two independent sample t-test and analysis of covariance. Results The av- erage age was 20.94~13.35 years （range 5-45 years）, five eyes were pseudophakic, one was aphakic and other twelve were phakic. According to the location of the corneal scar, it was found that nine eyes were in zone 1 and other nine in zone 2. The average length of scar was 4.04±2.23 mm （range 1.50-8.33 mm）. The difference in the length of scar between zone 1 and zone 2 was found to be not statistically significant （t =-0.967, P =0.348）. The interval from complete sutures removal to contact lens fitting was averaged 5：67±5.52 months （range 3-22 months）. Mean UCVA was 4.2±0.5 （range 3.0-4.9）. Mean SVA was 4.6±0.3 （range 4.0-4.9）. Mean RGPCLVA was 4.9±0.1 （range 4.4-5.1）. The visual acuities with contact lens were significantly better than with spectacles （t = 4.143, P 〈0.000）. RGPCLVA was 1 line better i

关 键 词：眼外伤 角膜不规则散光 硬性高透氧性角膜接触镜 

分 类 号：R779.7[医药卫生—眼科]