复曲面硬性透气性角膜接触镜矫正高度角膜散光

Toric rigid gas permeable contact lenses to correct high corneal astigmatism

目的观察后表面复曲面硬性透气性角膜接触镜（BSTRGPCL）矫正高度角膜散光的效果及其对角膜地形图的影响。方法选择高度角膜散光患者31例（54眼），经自动验光仪验光、客观检影、综合验光仪验光和角膜地形图检查，记录综合验光仪所得最佳矫正视力（BCVA），确认角膜散光与整体散光基本一致，根据2／3散光原则定制BSTRGPCL。戴镜1个月后复查，观察配适和眼表并发症情况，记录BCVA和角膜地形罔变化。采用SPSS13．0统计软件对所得数据进行x2检验和配对t检验分析。结果戴镜后1个月．所有患者配适良好，无严重眼表损伤和感染等并发症。配戴BSTRGPCL的视力较框架眼镜视力有明显提高，39眼（72122％）的BCVA≥1．0．例数显著多于框架眼镜矫正时（18眼，33．33％），差异有统计学意义（x2=16．38，P=0．00）。戴镜1个月后，角膜表面规则性指数、表面不对称性指数分别为13．66±0．21和0．36±0．18，较戴镜前无明显变化（t=1．01，P=0．32；t=1．40，P=0．17）；最大角膜曲率为（47．72±2．12）D，较戴镜前明显变低（t=2．42，P=0．02），最小角膜曲率为（42．70±2．04）D，无明显变化（t=0．05，P=0．97）。结论BSTRGPCL矫正高度角膜散光配适良好，可获得较理想的矫正视力，短期配戴可使最大角膜曲率降低．但角膜规则性变化不显著。

Objective To evaluate the effect of back surface toric gas permeable contact lenses （BSTRGPCL） to con＇ect high corneal astigmatism and changes in corneal topography. Methods Thirty-one patients （54 eyes） with high corneal astigmatism were recruited for the study. All the patients were examined by autorefractor, objective refraction and phoropter. Corneal topography was performed to make sure that corneal astigmatism was equal to whole eye astigmatism. The best corrected visual acuity （BCVA） examined by phoropter was recorded （spectacle corrected vision）. The two-third principle was followed to order BSTRGPCL. All patients had routine follow-up at 1 month. The fitting condition and ocular complications were evaluated. BCVA and corneal topography were recorded. Data analysis was performed using SPSS 13.0 software. A ehi-square test and paired sample t test were performed. Results All patients had a favorable fitting and no severe ocular surface eornplications were found. Thirty-nine eyes （72.22%） had a BCVA equal to or better than 1.0 by wearing BSTRGPCL, which was significantly higher than spectacle correction （18 eyes, 33.33%）. The differenee was statisfieally significant （X2=16.38, P=0.00）. The surface regularity index （SRI） and surface asymmetry index （SAI） were 0.66±0.21 and 0.36±0.18, respectively, which were not significantly changed （t=1.01, P=0.32; t=1.40, P=0.17）. Ks （steep K） was （47.7±2.12）D, which was a significant decrease compared to Ks before wearing BSTRGPCL（t=2.42, P=0.02）. Kf （flat K） was （42.70±2.04）D, and the change was not significant （t=0.05, P=0.97）. Conclusion Satisfactory visual acuity correction and fitting are obtained by fitting BSTRGPCL on eyes with high corneal astigmatism. Corneal regularity does not significantly change while Ks significantly decreased with short-term wear.