透气性硬性角膜接触镜矫正特殊屈光不正的临床应用

Clinical application of rigid gas permeable contact lens to correct special refractive error

目的观察透气性硬性角膜接触镜(rigid gas-permeable contact lens,RGP CL)矫正特殊屈光不正的临床应用效果。方法对35例63眼特殊屈光不正进行RGP CL验配,观察其有效性(矫正视力)、安全性(角膜染色、角膜内皮计数、眼压、角膜Q值、泪膜破裂时间)、控制近视效果(眼轴、视力、屈光度)、依从性(随访次数、护理情况)。结果 RGP CL 7 d矫正视力(0.95±0.03),与框架眼镜矫正视力比较差异有统计学意义(t=2.47,P=0.01);1年后泪膜破裂时间为(12.50±3.82)(st=0.91、P=0.34),角膜内皮计数(3109±138)个/mm(2t=-0.62,P=0.53),眼压为(15.9±1.77)mmHg(t=-0.3,P=0.76),Q值为(-0.21±0.22)(t=-1.53,P=0.87),眼轴长度为(27.34±0.91)mm(t=-0.86,P=0.39),等效球镜为(-7.95±0.71)DS(t=-1.06,P=0.31),与配戴前比较差异均无统计学意义;6%出现角膜荧光素染色;94%自行摘戴护理镜片,87.5%按时复诊。结论RGPCL配戴安全、有效、依从性好,能有效矫正各种疑难屈光不正、能控制青少年近视的发展。

[Objective] To observe clinical effects of rigid gas permeable contact lens （RGP CL） correct special refractive error. [Methods] The clinical datas of 63 eyes of 35 patients wearing RGP CL. The effects, the compliance, the safety, the control myopia development were analyzed, includes CVA of RGP CL, the number of follow-up visit, nursing RGP CL, break up time, cornea staining, the number of corneal endothelial cells, intraocular pressure, the Q value of the cornea, axial length, mean spherical equivalent （MSE）. [Re- suits] There was significant difference in the CVA after wearing RGP CL for 7 days to CVA of wearing glasses （t =2.47, P=0.01）. Compare to before wearing RGP CL, there was no significant difference in break up time, the number of corneal endothelial cells, intraocular pressure, Q value of the cornea, axial length, MSE of wearing it for 1 year （t=0.91, P=0.34, t=-0.62, P=0.53, t=-0.3, P=0.76, t=-1.53, P=0.87, t=- 0.86, P =0.39, t =-1.06, P=0.31）. The cornea staining of 6% RGP CLwearer were examined. Wearing and nursing RGP CL by 94% wearer by oneself, 87.5% RGP CL wearer follow-up visit on schedule. [Conclu- sion] RGP CL correct special refractive error is effective, safety and good compliance and can control mvonia development.