硬性角膜接触镜对圆锥角膜矫治作用  

Observation of the correcting effect for keratoconus patients with rigid gas-permeable lenses

作　　者：孟艳菊[1] 郑曰忠[1] 

机构地区：[1]天津市眼科医院验光配镜中心,天津300020

出　　处：《中国实用眼科杂志》2014年第9期1052-1055,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察硬性透气性角膜接触镜（rigid gas permeable contact lens，RGPCL）对圆锥角膜患者的屈光矫正作用。方法临床病例系列研究。收集2010年1月至2012年12月在天津市眼科医院就诊的圆锥角膜患者40例（72只眼），根据最大拟似角膜计值（SimKmax）将患者分为两组：SimKmax《47 D为轻度组，共24例（43只眼）；SimKmax》47 D为中重度组，共16例（29只眼）。分别观察两组患者配戴RGPCL前后的最佳矫正视力、角膜地形图变化和眼部病变进展情况。结果在40例（72只眼）中，38例（70只眼）圆锥角膜患者完成12个月随访，并通过配戴RGPCL后均获得较好的矫正视力（0.6-1.0），角膜病变进展得到一定缓解，未发现有眼部明显并发症。另2例（2只眼）中，有1例轻度组患者（1只眼）因配戴后无法适应而放弃使用；余1例中重度组患者（1只眼）因病情加重和矫正视力下降，在戴镜3个月后行穿透性角膜移植手术。结论科学合理地长期配戴RGPCL，可使圆锥角膜患者获得较好地矫正视力．延缓病情进展或推迟角膜手术时间。Objective To evaluate the treatment efficacy of rigid gas permeable contact lens （RG- PCL） for correcting the irregular astigmatism patients with keratoconus. Methods From January 2010 to December 2012, a retrospective analysis of 72 eyes from 40 patients with keratoconus were collected in our hospital. According to the Sire Kmax value, the keratoconus were divided into two groups： the mild keratoconus group and the moderate to severe keratoconus group. Sim Kmax 《 47 D was the mild keratoconus group （24 patients, 43 eyes）, and Sim Kmax》47D was the moderate to severe keratoconus group （16 patients, 29 eyes）. The best corrected visual acuity, the findings with slit-lamp microscopes and the change of ocular health were observed at beginning, six and twelve months after the fitting with RGPCL. Results Among the 40 patients （72 eyes）, there were 38 patients （70 eyes） completed the 12 months＇ follow up. The good corrected visual acuity was observed in all of the patients who completed the 12 months＇ follow up after fitting with RGPCL. The progression of corneal ectasia was prevented and the ocular complications with RGPCL were not found. Among another two patients （2 eyes）, One patient （one eye） in mild group was given up because of intolerance with the fitting. Another one patient （one eye） in the moderate to severe group was received the penetrating keratoplasty because of the progression of the corneal ectasia and decreased of visual acuity. Conclusions The exciting fitting with RGPCL for the patients with severe keratoconus with a longtime could significantly improve the corrected visual acuity, and prevent the progression of corneal ectasia or delay the time of the keratoplasty operation.

关 键 词：圆锥角膜 硬性透气性角膜接触镜 矫正视力 

分 类 号：R772.2[医药卫生—眼科]