佩戴硬性高透气性角膜接触镜对圆锥角膜的效果  

The efficacy of wearing rigid gas permeable corneal contact lens in patients with keratoconus

作　　者：李秀红[1] 王卫群[1] 吕勇[1] Li Xiuhong;Wang Weiqun;Lyu Yong(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2022年第9期680-685,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省科技厅重点研发与推广专项项目(201801591);河南省教育厅高等学校重点科研项目(22A320024);河南省软科学研究, "健康中国"背景下河南省青少年近视协同治理体系的构建与实施路径分析(222400410070)。

摘　　要：目的分析佩戴硬性高透气性角膜接触镜(RGP)对轻中度圆锥角膜进展的控制效果。方法回顾性病例系列研究。纳入郑州大学第一附属医院2011至2017年验配RGP、佩戴2年后更换镜片的轻中度圆锥角膜45例(74眼), 比较佩戴前及佩戴2年后屈光度及视力等各项参数。结果佩戴RGP前后两次最陡经线上角膜屈光力[(52.03±7.93)D与(51.52±6.52)D]、中央角膜厚度[(467.69±74.59)μm与(469.05±68.69)μm]、适配RGP基弧[(7.22±0.64)mm与(7.23±0.61)mm]、RGP屈光度[(-7.11±4.01)D与(-7.62±4.84)D]相比差异均无统计学意义(t=0.90、-0.24、-0.30、1.29;P=0.369、0.814、0.768、0.203);而代表角膜前表面平均散光的Simk’s散光值在佩戴2年后为(-2.75±2.31)D低于佩戴前的(-3.88±3.02)D(t=-4.08, P<0.001)、RGP视力(logMAR)0.02±0.09较初戴时的0.06±0.09提高(t=-3.55, P=0.001)。距角膜中央3.0 mm以内及3.1~5.0 mm两区域内的平均角膜屈光力在佩戴后2年均有所增加(t=-2.67, P=0.010;t=-5.04, P<0.001)。而5.1~7.0 mm区域的平均角膜屈光力及角膜散光在配戴后2年却有所减小(t=2.00,P=0.049;t=3.70, P<0.001)。结论佩戴RGP能有效控制轻中度圆锥角膜进展。Objective To analyze the efficacy of wearing rigid gas permeable corneal contact lens(RGP)for mild or moderate keratoconus.Methods This was a retrospective case series study.A total of 74 eyes of 45 patients with mild or moderate keratoconus wearing RGP,from 2011 to 2017 in the First Affiliated Hospital of Zhengzhou University,whose RGP lens were renewed after wearing 2 years,were included.The diopter and visual acuity and other parameters were analyzed before and after wearing RGP for 2 years.Results There was no statistical difference in the results of the two steepest corneal refractive power[(52.03±7.93)D and(51.52±6.52)D],central corneal thickness[(467.69±74.59)μm and(469.05±68.69)μm],base curve[(7.22±0.64)mm and(7.23±0.61)mm],diopter[(-7.11±4.01)D and(-7.62±4.84)D],between before and after wearing RGP for two years(t=0.90,0.24,0.30,1.29;P=0.369,0.814,0.768,0.203).But the Simk’s values of astigmatism which on behalf of the corneal surface average astigmatism was(-2.75±2.31)D,which was lower than the(-3.88±3.02)D before wearing RGP(t=-4.08,P<0.001).The visual acuity(logMAR)of appropriate RGP was 0.02±0.09 after wearing RGP for 2 years,which was better than the 0.06±0.09 at the beginning of wearing RGP(t=-3.55,P=0.001).The average corneal refractive power within 3.0 mm and 3.1-5.0 mm from central cornea increased after wearing RGP for 2 years(t=2.67,P=0.010;t=5.04,P<0.001).But average corneal refractive power and corneal astigmatism in 5.1-7.0 mm area decreased after wearing RGP for 2 years(t=2.00,P=0.049;t=3.70,P<0.001).Conclusion Wearing appropriate RGP can effectively control disease progression of mild or moderate keratoconus.

关 键 词：圆锥角膜 镜 接触 角膜 透气性 硬性 效果 控制 原因 控制 

分 类 号：R772.2[医药卫生—眼科]