三弧反转设计RGP镜片在角膜屈光术后屈光回退患者中的应用  

Application of Three-arc Reversal Design RGP Lens in Patients with Refractive Regression after Corneal Refractive Surgery

作　　者：刘建和 何妙玲 吕红丽 LIU Jianhe;HE Miaoling;LYU Hongli(Xiamen Eye Center of Xiamen University,Xiamen 361001,China)

机构地区：[1]厦门大学附属厦门眼科中心,福建厦门361001

出　　处：《中国医药指南》2022年第35期25-28,共4页Guide of China Medicine

摘　　要：目的探讨角膜屈光术后屈光回退患者验配三弧反转设计RGP镜片的有效性、可行性和安全性。方法对角膜屈光术后屈光回退患者12例20眼进行三弧反转设计RGP镜片的验配,通过角膜地形图分析设计个性化三弧反转RGP镜片,记录戴镜前的裸眼视力、框架镜最佳矫正视力和戴RGP的最佳矫正视力;在随访过程中,观察并记录RGP镜片配戴适应情况、视力矫正效果、视觉质量以及并发症。结果20眼成功验配三弧反转设计RGP镜片,戴RGP前裸眼视力0.05~0.30者5只眼,0.30~0.80者15只眼;戴RGP前框架镜最佳矫正视力在0.20~0.50者5只眼,0.60~1.00者15只眼;戴RGP的最佳矫正视力在0.70~0.90者4只眼,1.0者16只眼,其中15只眼(75.00%)矫正视力较框架眼镜更好,12例(100.00%)矫正视力等同或优于框架镜。裂隙灯检查可见镜片与角膜形态吻合度更佳,活动度较普通球面设计RGP更小。全部患者主诉眩光、光晕等视觉症状在配戴RGP后得到改善,视觉质量良好,夜间视力及对比敏感度显著提高,平均随访20个月,未见角膜上皮染色等角膜接触镜相关的并发症。结论角膜屈光术后屈光回退患者验配三弧反转设计RGP镜片安全有效,且视觉矫正效果更佳,配戴舒适度更好。Objective To investigate the effectiveness,feasibility and safety of three-arc reversal design RGP lens for corneal refractive regression after refractive surgery.Methods A total of 20 eyes of 12 patients with refractive regression after corneal refractive surgery were fitted with threearc inversion RGP lenses.The personalized three-arc inversion RGP lenses were designed by corneal topographic map analysis.The uncorrected visual acuity before wearing the lens,the best corrected visual acuity with frame lens and the best corrected visual acuity with RGP were recorded.During the follow-up,the adjustment of RGP lens wearing,visual correction effect,visual quality and complications were observed and recorded.Results Twenty eyes were fitted with RGP lenses successfully.The uncorrected visual acuity was 0.05-0.30 in 5 eyes and 0.30-0.80 in 15 eyes before wearing RGP.The best corrected visual acuity was 0.20-0.50 in 5 eyes and 0.60-1.00 in 15 eyes.The best corrected visual acuity of RGP was 0.70-0.90 in 4 eyes and 1.0 in 16 eyes.The corrected visual acuity of 15 eyes(75.00%)was better than that of frame glasses,and the corrected visual acuity of 12 eyes(100.00%)was equal or better than that of frame glasses.The slit lamp examination showed that the lens was more consistent with the shape of the cornea,and the range of motion was smaller than that of the spherical design RGP.All patients complained that the visual symptoms such as glare and halo were improved after wearing RGP.The visual quality was good,and the night visual acuity and contrast sensitivity were significantly improved.No corneal epithelial staining and other contact lens related complications were observed during an average follow-up of 20 months.Conclusion The three-arc reversal design RGP lens is safe and effective for patients with refractive regression after corneal refractive surgery,and the visual correction effect is better,and the wearing comfort is better.

关 键 词：角膜屈光术后 屈光回退 三弧反转设计 RGP镜片 

分 类 号：R772.2[医药卫生—眼科]